Dependent upon the size and location of the defect, it may be closed directly with sutures or with a patch. Once the defect is closed, the atrial incision is closed as well. The aortic cross clamp is removed, and after normal ventilation is resumed, the patient is warmed and a stable rhythm is achieved , the patient may be weaned from cardiopulmonary bypass. A single drainage tube is placed and the chest is closed. The results of surgical repair of atrial septal defects are excellent.
Surgical mortality is less than one percent, and average hospital stay is four days.
These results indicate that ASD's of all types may be effectively repaired in infants and children with very low mortality and morbidity. Optimal timing for surgery in the asymptomatic child remains prior to starting grade school. The asymptomatic child with an atrial septal defect deserves close follow-up by the pediatrician and pediatric cardiologist, with constant involvement of the cardiovascular surgeon. In the 1990s, however, marked improvement in surgical technique has contributed to the significantly improved outcomes reported above. In light of this history, interventional cardiologists explored the possibility of transcatheter closure of the atrial septal defect.