Atrial Septal Defect (ASD)
What Is It?
An atrium is a
chamber or cavity. A septum is a partition. An atrial septal defect (ASD) is an opening
between the walls of the two upper chambers of the heart.
The defect may be
present at birth, but is not always detected until later in life. This opening affects the
normal flow of blood through the heart and lungs and may cause shortness of breath,
fatigue, or frequent respiratory infections.
How
Is an ASD Diagnosed and Treated?
Your physician
may order an echocardiogram and/or a
cardiac catheterization to determine the
exact size and location of the defect.
An ASD can be
repaired surgically by sewing a patch over the opening. This patch may be made of a
Dacron™-type material, or your surgeon may use a small piece of your pericardium. The
pericardium is a loose sac of tissue which surrounds your heart for protection. Taking a
small piece of this tissue will not harm your heart and provides a permanent closure for
the ASD.
What
Can you Expect During Recovery From Repair of an ASD?
While you are
recovering it is important to remember that YOUR participation and motivation are key.
Day of Surgery
The operating
room has been prepared especially for your surgery. The anesthesiologist you meet the
night before will give you medication, which will make you drowsy.
After you are
asleep, your circulation and breathing will be taken over by a heart-lung machine.
This
machine circulates blood throughout your body while your heart is stopped, enabling
the surgeon to repair the ASD. When the surgery is finished, your heart function will be
returned, and the heart-lung machine will be removed.
After surgery,
you should expect to wake up in the surgical intensive care unit (SICU) where you will
remain overnight. The following day you can expect to be transferred to a regular room.
You will have an incision along your sternum or breastbone which may or may not cause you
some discomfort. Pain medicine is available for you at your request.
Helping Your Lungs Return to Normal
Your lungs are of
primary concern during your hospital recovery. Anesthesia, surgical manipulation, and pain
will all affect your lung function after surgery.
Use your
incentive spirometer the night before your surgery and mark the level you obtain. This
will give you the goal to strive for during recovery. In addition to using your incentive
spirometer ten times each hour, deep breathing and coughing will help your lungs get back
into shape.
Your nurse will
show you how to support your incision during coughing, and provide pain medication so that
coughing can be performed with minimal discomfort.
Activity: Helping All Your Body Systems
Return to Normal
Chest tubes were
inserted during surgery to promote extra drainage from your chest. While the chest tubes
are in place, your activity may be somewhat limited. You will be encouraged to get out of
bed for your meals, and use the bathroom in your room. You will need assistance the first
few times out of bed.
As you feel
stronger, in addition to being out of bed during your meals, you will be encouraged to
walk in the hallway at least three times each day. You will tire easily the first few
days, so frequent rest periods are encouraged, including a nap in the middle of the day
Increasing your
activity gradually will allow your heart, lungs, and appetite to improve over time. Be
patient with yourself, but stay motivated.
What Can
You Do to Help Speed Your Recovery?
Cardiac Rehabilitation Programs
Your surgeon may
recommend that you participate in an outpatient cardiac rehabilitation program.
Information about these programs and the name of the program located closest to you will
be given to you before discharge.
General Activity Guidelines and Restrictions
Do not lift
anything heavier than ten pounds.
Do not drive for
four weeks. You may ride in a car; please wear your seatbelt.
Walk every day.
Increase your distance gradually. Avoid walking in extreme weather. Shopping malls provide
an excellent place for walking inside during extreme weather.
Rest after
activity. Elevate your legs while seated to minimize swelling.
You may climb
stairs. Do it slowly and rest if you need to.
You may perform
light household chores such as dusting, food preparation, folding laundry, washing dishes,
etc.
Resuming Sexual Activity
Allow yourself
and your partner time to discuss concerns and feelings during recovery. When you both feel
the time is right to resume lovemaking, follow a few guidelines.
The amount of
stress on your heart during sexual intercourse is about the same as climbing two flights
of stairs. If you feel comfortable with this level of activity, follow these guidelines
and enjoy.
Don’t strain
your arms or breastbone, which means you may need to try new positions.
Wait one to three
hours after eating.
Avoid alcohol.
Choose a relaxed
time free from interruptions.
Understanding Your Feelings
During recovery,
it is normal to experience a wide variety of emotions. You may wonder if you will ever
feel like yourself again. Your moods may vary from day to day, and leave you feeling
frustrated, sad, or irritable.
Your attitude
toward your situation is most important. Keep a positive outlook by participating in
recreational activities you enjoy, such as going to the movies, playing cards, or going to
church. You can resume your favorite hobby, following the activity guidelines. Keeping
your mind occupied will help hasten your recovery in a pleasurable way.
Appetite and Nutrition
It is normal to have a decrease in appetite and feel
nauseated for several days after surgery. Nutrients and calories are very important for
your body to heal properly. Frequent, small meals may be better tolerated than three large
ones.
About Your Incisions
During the
surgery, an incision was made along the center of your breastbone or sternum. After
surgery, this incision may feel tight, sore, or numb. The skin around the incision may
look bruised or slightly reddened. This will improve with time.
You may notice
some clear, pinkish fluid draining from your chest or from the smaller incisions below
your chest where the chest tubes had been. This not unusual.
You may also
experience some back and shoulder discomfort which may be lessened with good posture,
simple neck and shoulder exercises to prevent stiffness, or a heating pad set on the
LOWEST setting. Wash your incisions gently each day while you shower.
When
Should You Notify Your Physician?
Watch for these
signs which should be reported to your surgeon or family physician:
- Fever greater
than 101 degrees F,
- Thick yellow
drainage, or an increase in the amount of drainage from any incisions,
- Increased pain,
heat or redness at the incision sites, or
- Difficulty
breathing while at rest.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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