The procedure that closes the defect known as an atrial septal defect, or ASD; and a smaller defect which causes stroke, called patent foramen ovale, or PFO takes a much different route than the past use of open-heart surgery. Doctors open a vein/vessel near the groin and insert a long, thin tube called a catheter.
The catheter, loaded with an alloy device called an Amplatzer septal occluder, is guided into the interior of the heart. Once in place, the occluder is released, and it expands into a circular coil that closes the hole.
About 15 years ago, almost 90% of these type of congenital heart defects were repaired through open-heart surgery, said TTP El Paso interventional cardiologist Harsha Nagarajarao, M.D., who serves as co-director of the Cardiovascular Catheterization Laboratory at University Medical Center of El Paso. Today, the transcatheter coil occlusion procedure is widely used across the world to treat heart holes.
Dr. Nagarajarao and other TTP El Paso interventional cardiologists perform the procedure at UMC. TTP El Paso is the clinical practice of Texas Tech University Health Sciences Center El Paso.
Dr. Nagarajarao said up to 25% of people are born with this kind of hole in the heart. Not all of them will require surgery, but those that present with stroke will need to have the hole closed, he said.
Dr. Nagarajarao, who also serves as an assistant professor in the division of cardiology at TTUHSC El Paso, adds that there is a large, unmet need in the area for treating this type of heart defect. To help increase the numbers of physicians capable of treating the defect, Dr. Nagarajarao is helping train TTP El Paso physicians for certification in the procedure.
Earlier this year, a 36-year-old man who suffered multiple strokes over two years with no indication of a cause was referred by TTP El Paso's neurology department to Dr. Nagarajarao's cardiology team. The doctors determined he had a PFO which was responsible for his stroke and scheduled him for the coil occlusion procedure.
The surgery, performed by Dr. Nagarajarao, was a success and significantly reduced the risk of stroke for the patient. The surgery took about two hours and required only light anesthesia.