Asd in children: treatment of atrial septal defect

Hadassah annually performs hundreds of successful atrial septal defect closures. The procedure is conducted for children weighing more than 1 kg 400 gr, and adult patients of all ages


«Dear Parents!

Those whose children, unfortunately, are faced this disease, often fall into confusion and do not know who to turn to.

I will be glad to answer all your questions about the ASD diagnostics and treatment in our medical center. Send me an email or make an appointment

Health to you and your kids!»

Prof. Eldad Erez

Read Professor Erez’s interview "Child`s heart"


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In the clinic, ASD correction is performed using the ultra-modern AMPLATZERself-opening occluders. The occluders are inserted using thin catheters. This is a non-surgical, minimally invasive procedure. Catheterization is performed by world-renowned cardiologists such as Professor Eldad Erez, who constantly participates in reports on the unique children`s treatment, included in the list of the best Israeli doctors published by Forbes magazine 2018.


Atrial septal defect: treatment and diagnostics in Israel, at the Pediatric Cardiology and Cardiac Surgery Center, the Hadassah MC

Watch a video on how the cardiovascular diseases diagnostics is carried out in the Hadassah MC

What if your newborn baby is diagnosed with an atrial septal defect? Will the defect close itself or do you need to treat it? It is known that in order for the defect closure to be as successful as possible, it must be carried out in early childhood – otherwise there is a risk of the formation of irreversible changes in the lungs, heart, liver. And with the incorrect or incompetent treatment consequences the child will have to live his whole life.

That is why parents should get as much information as possible about ASD in children, learn about diagnostic and treatment methods of atrial septal defect in order to make the best decision. Prof. Eldad Erez, a leading specialist of the Pediatric Cardiac Surgery Department at the Hadassah MC with extensive experience in the surgical treatment of atrial septal defect in children, has prepared an article telling about:

  • What lies behind the atrial septal defect diagnosis in a newborns and children?
  • What are the types of the disease?
  • What are the best ASD diagnostic and treatment methods for children?
  • How is atrial septal defect treated in the Hadassah MC (Israel)?

What is ASD in children?

Unlike a ventricular septal defect, a septal defect between the atria never closes on its own. Therefore, it is one of the most common birth defects diagnosed in children over three years old. Atrial septal defect occurs with 3-20% frequency of all congenital heart defects cases. The defect can be very small, or it can lie in the complete absence of a septum between the left and right atria.

In case of a severe defect, blood from the left atrium (saturated with oxygen) enters the right atrium again, and again passes through the lungs – although it can no longer receive additional oxygen from them – thus reducing the efficiency of blood circulation and creating unnecessary stress on the heart and lungs.

Types of ASD in children

Atrial septal defects are formed in the embryonic period as a result of impaired development of the primary or secondary interatrial septum. Depending on the defect location, several ASD types in children are considered. The most common are:

  • defects of the secondary septum, in which the opening is located in the middle of the interatrial septum.
  • defects of the venous sinus located in the upper part (in this defect type, a violation of the structure of the pulmonary veins is often found – abnormal drainage when the pulmonary veins flow into the superior vena cava).
  • defects of the primary septum – holes located in the lower part of the septum (in some cases they also affect the valve cusps – mitral or triscupid – and even the interventricular septum).

If this defect is left unattended, then as a child becomes older he may experience irreversible changes in organs such as the lungs, heart and liver.

ASD treatment in children in Israel: Cardiology and Cardiac Surgery Center, the Hadassah MC

Surgery in order to close the defect is the only treatment for an atrial septal defect. It is usually planned for the age from 3 to 6 years, not postponing until the development of possible complications. And the more experienced the cardiac surgeon is, the more successful the surgical intervention will be performed. At the Pediatric Cardiology and Cardiac Surgery Center, atrial septal defect in children is treated by prof. Eldad Erez, who carried out many successful ASD surgeries in children.  

You can personally contact prof. Erez using the contact form below:

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Preoperative ASD diagnostics

Auscultation: during heart auscultation the doctor can hear a characteristic systolic heart murmur, which makes it possible to diagnose an atrial septal defect. At the same time, the noise is not loud or harsh, as with some other defects.

  • Echocardiography is the main diagnostic tool. It allows you to visualize the ASD, determine its location, as well as in which direction the blood is shunted through the hole (that is, the shunting direction).
  • An electrocardiogram allows you to determine if there is an overload caused by an atrial septal defect.
  • An X-ray shows whether pathological changes have occurred in the lungs due to increased pressure in them.
  • Treatment methods of atrial septal defect

    At the Hadassah MC, the treatment method is individually selected for each patient. An important role for decision-making is played by such factors as:

    • the patient’s age,
    • the child’s general health and medical history;.
    • ASD type;
    • the child’s reaction to medications, procedures and treatment methods;
    • prognosis of the further disease course;.
    • preferences of parents and family members.

    Due to an individual approach, the number of complications after ASD closure surgery in children is significantly reduced.

    Types of surgery to eliminate atrial septal defect:

    • open heart surgery.

      When an open heart operation is performed, the patient is transferred to a heart-lung machine, after which the defect (if it does not exceed 1.2 cm) is sutured. Larger defects are closed with a patch.

    • minimally invasive method of treating atrial septal defect.

      Not so long ago, a brand new minimally invasive method of treating atrial septal defect was developed, which allows you to avoid open heart surgery. It is called endovascular method and it consists in bringing a special device to the hole using a catheter inserted through a puncture in the femoral vein. The device that closes the defect is called an occluder. This procedure takes much less time, causes much less trauma and inconvenience to patients, and does not require general anesthesia. A few days after such an operation, a child can already have a normal life. However, not every patient is suitable for this procedure. For example, the development of increased pressure in the lungs vessels and the shunt through the opening from the right atrium to the left is a contraindication for the surgery.

    If you have any questions about the operation, you can send them using the contact form at the bottom of the page or by following the link

    ASD treatment in children: after surgery

    With timely treatment, most young patients do not experience serious symptoms of the defect or its complications, and have an excellent prognosis for a healthy future.

    Follow-up care

    Postoperative follow-up care and periodic examinations by a specialist are no less important stage of treatment than the surgery itself! You can show your child to an experienced pediatric cardiac surgeon at the place of residence. In addition, if a child was operated at the Hadassah MC, you can always contact our doctors by phone or the Internet and ask a question that worries you.

    Peculiarities of ASD treatment in children in Israel: “Mother and Child” center in the Hadassah MC

    Children undergoing treatment at the Hadassah MC, including children with ASD, have been allocated a separate building – the Hadassah Children’s Clinic, decorated in a special way and specifically equipped for children’s needs. Parents accompany their children during all procedures carried out using the most painless methods. In cases where surgery is required, parents can be in the operating room both at the time of the anesthesia introduction, and immediately before the end of its action. So that the children have the impression that their parents were with them all the time. A multidisciplinary team, which includes not only doctors, but also teachers, psychologists and even special hospital clowns, constantly monitors the child`s condition and mood and tries to do everything so that the child is not afraid and, if possible, is not hurt while he is undergoing treatment.

    ASD treatment in children in Israel: organizational issues

    The international department employees of the Hadassah MC will help to organize the diagnostics and treatment of a child with ASD with the best pediatric cardiac surgeons of our hospital in the shortest possible time. In order to find out more information about the treatment of CHD ASD in our Pediatric Cardiology and Cardiac Surgery Center, as well as to receive a preliminary medical plan and a treatment cost, you can:

    • send us an email to info@hadassah-hospital.org
    • leave a request to the international department of the clinic:
    • call the hotline +972(2)560-94-38

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    Hadassah University Hospital, Israel

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    Please fill out the form and our representative of the International Department will contact you (free of charge)