Device closes holes in the heart without surgery

Holes in the heart can be closed – without surgery – using an Amplatzer® Occluder device which is implanted in the Cath Lab.

At Baptist Hospital East, Cardiologist Thomas Tu, M.D., performs the procedure to correct two types of heart defects in adults: atrial septal defects (ASDs) which are openings in the wall between the heart’s upper chambers, and patent foramen ovales (PFOs) which are gaps between overlapping sections of the wall dividing the upper chambers.

With the device, patients with heart defects can be treated without open-heart surgery, chest wall incisions and lengthy recoveries. Instead, the defects are repaired through a catheter inserted in the groin. Most patients go home from the hospital the next day.

“With either procedure, the results are excellent and immediate,” Tu said. Each procedure takes less than an hour to perform.

The Occluder – which looks something like an umbrella – is made of two flexible metal disks. It folds down to fit into the small catheter, but expands when deployed. The two disks are positioned to sandwich the heart defect, then snapped tightly together to close the hole. “The heart will grow tissue over the device – it becomes part of the heart,” Tu said. “Once this occurs, the hole is closed permanently.”

PFO patients are typically younger people (teens to 30s) who have suffered a cyptogenic stroke, or a stroke with no apparent cause.

During fetal development, blood flow between the heart’s chambers is more open, but closes after birth. For about 30 percent of all adults, a residual hole – or PFO – is still there. The hole can “pop open” when the person bears down or strains, sending a rush of blood and blood clots from the venous to the arterial side of the heart. This can cause stroke or heart attack.

One treatment is to put the person on blood thinners for the rest of his or her life to reduce stroke risk. “For a young person, this can be very lifestyle-limiting,” Tu said. “Women of child-bearing age cannot become pregnant because of the potential side effects on the baby.

For PFO patients who have had a stroke – and are unable to take blood thinners – the federal Food and Drug Administration has approved the Occluder as another option. Patients must meet both conditions in order for the device to be used.

“These are young people who want better solutions,” Tu said.

ASD symptoms usually crop up in childhood. But, for some, the congenital heart defect isn’t apparent until much later. The person may become easily fatigued, short of breath and may have an irregular heartbeat. ASDs account for 10 percent of all congenital heart disease; women are more prone to have the condition.

A similar Occluder device is implanted to correct an ASD.

After the procedure, patients are required to take an aspirin a day for the next six months.