Heart defect fixed with less invasive procedure

Heart defect fixed with less invasive procedure

URBANA — A potentially risky heart defect that can go quietly hidden from birth well into adulthood is now being repaired in a minimally invasive procedure at Carle Foundation Hospital.

Once, fixing a hole in the heart required open-heart surgery, said Dr. Sanjay Mehta, Carle's lead interventional cardiologist. Last month, he used a newer option to fix this condition, which is called an atrial septal defect.

Metha repaired a hole in a 39-year-old woman's heart with a catheter procedure. The catheter, a thin tube, goes in through the groin area to the heart, and a metal patch is threaded up to close up the hole.

Everyone starts out life with an opening between the upper chambers of the heart to allow for blood circulation. For most people, the hole closes at birth when the baby takes his or her first breath, Mehta said.

But up to 20 percent of people are left with a pin-sized hole that may never cause a problem, and some people are left with larger holes, which are referred to as atrial septal defects, he said.

These defects can be detected and repaired during childhood, but for some people, they remain undetected into adulthood, posing a risk for stroke, congestive heart failure, irregular heart rhythm and even death, Mehta said.

Symptoms for this condition can include shortness of breath and heart palpitations in adults, along with frequent respiratory infections in children.

The woman who was the first person to undergo the procedure at Carle didn't know she had a sizeable hole in her heart until she complained of feeling tired and doctors found it through an echocardiogram, Mehta said.

Before last month, a local patient with an atrial septal defect had the option of open-heart surgery in this community or traveling out of town for a minimally invasive procedure, Mehta said.

"Now we can get this done locally," he said of the less-invasive option.

Carle is offering the procedure for adults only. Children with this heart defect must still undergo a surgery at a hospital with a pediatric heart specialist, Mehta said.

Adults who undergo the procedure are in and out of the hospital in a day or two and generally can go back to work in a week, Mehta said. The patch covering the hole in the patient's heart is covered by the patient's own tissue within about six months of the surgery, he said.

Patients take aspirin and antibiotics afterward to reduce post-procedure complications, Mehta said.

For this surgery, Carle is using a device called the Amplatzer Septal Occluder, approved by the Food and Drug Administration in 2001.

In October, the FDA issued an alert to health care providers and patients that in "very rare instances," the Amplatzer device can break down and result in life-threatening emergencies that require immediate surgery. This happens in every one-to-three out of 1,000 patients implanted with the Amplatzer device, with 100 reports of erosions between 2002 and 2011, according to the FDA.

Patients who have the Amplatzer device weren't advised by the FDA to have it removed, but rather to be alert to signs of chest pain, numbness, sudden weakness, dizziness, fainting, shortness of breath and rapid heartbeat.

Mehta said major risks with this procedure are rare and patients are followed closely for this and any complication — both clinically and with an echocardiogram — at three, six and 12 months afterward, and after that once a year.

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