Cardiac Closure Devices and Its Importance

Introduction

Cardiac closure devices are of utmost importance. Cardiac closure devices have been utilized for many decades. Approximately out of ten thousand babies, six to ten babies have atrial septal defects or patent foramen ovale by birth. These cardiac closure devices are placed in individuals of all age groups and are very common and utilized to separate the atria.

What Are Cardiac Closure Devices?

The cardiac closure devices are utilized for atrial septal defects and in cases of patent foramen ovale.

• Atrial Septal Defects (ASD): The upper right and left chambers of the heart (atria) are separated from each other with the help of the interatrial septum. However, a hole in the interatrial septum separates the two atria in the atrial septal defects. In such cases, cardiac closure devices are utilized to close the hole and avoid mixing blood in the heart.

• Patent Foramen Ovale: In these cases, there is a space in the interatrial septum but not a hole. The fetus utilizes the foramen ovale for normal fetal circulation. This foramen closes after birth. If this foramen is still present after the delivery of the fetus, it is called patent foramen ovale. In such cases, cardiac closure devices are utilized if they exhibit symptoms.

What Are the Different Types of Cardiac Closure Devices?

The different types of cardiac closure devices are as follows:

• Amplatzer septal occluder.

• Amplatzer PFO (patent foramen ovale) occluder.

• Amplatzer cribriform (for a septum with more than one hole).

• Gore cardioform septal occluder.

• Gore cardioform ASD occluder (for larger ASDs).

• STARFlex septal closure system.

What Is the Need for Cardiac Closure Devices?

• They might require a cardiac closure device if they have a hole in the wall separating the left and right atria. This is because the blood in the left and right atrium are kept apart by closing this opening. This is significant because the blood in the right atrium does not contain oxygen but does in the left atrium.

• When blood from the atria mixes, the heart cannot supply the body with enough oxygen. Therefore, all blood should be oxygenated before entering the left atrium and reaching the body's cells.

Additionally, medical professionals use ASD closure devices to stop strokes in patients with patent foramen ovale (PFO). Like an ASD, this opening enables blood to flow against gravity inside the heart.

How Does the Physician Place Cardiac Closure Devices?

• Cardiologists or surgeons can use a catheter to implant ASD closure devices during open-heart surgery. However, cardiac catheterization enables medical professionals to address the problem instead of open-heart surgery. As a result, doctors now use cardiovascular catheterization to treat more than eight percent of ASDs.

• The size of ASD closure devices can vary from four millimeters to forty millimeters. Service providers' equipment to install the device comes in different sizes. For the device they are placing, they can select the right size. The size of the device's opening will need to be measured using a balloon inserted through a catheter.

• A physician inserts a specific catheter into the heart through a leg vein to use it to seal a PFO or ASD. Each edge of the device is gently pushed out of the catheter, enabling it to cover the opening on all sides. When the gadget is in the appropriate location, it is released under ultrasound and X-ray supervision.

What Are the Advantages of Cardiac Closure Devices?

Transcatheter ASD closure devices are equally effective and secure as those implanted during open-heart surgery, according to research. However, they can anticipate less discomfort and a shorter hospital stay if they receive an ASD closure device during cardiac catheterization.

According to research, it is preferable to implant a cardiac closure device utilizing a catheter to treat a PFO.

What Are the Side Effects of Cardiac Closure Devices?

The side effects of cardiac closure devices are as follows:

• Aortic insufficiency (blood flowing backward from the aortic valve).

• Blood clots.

• Abnormal heart rhythms.

• The device is moving out of place.

• Endocarditis from dental procedures.

• ASD closure device leak (most stop leaking during the first year).

• Difficulty accessing the left atrium in the future.

• Device erosion.

How to Prevent the Side Effects of Cardiac Closure Devices?

The following methods can be adopted to prevent the side effects:

After having an ASD closure device, the doctor will advise taking an anticoagulant for six months to avoid blood clots. Catheters can be passed through using updated devices that are available to providers. The latest systems still permit catheters to pass through them to access the left atrium for operations like atrial fibrillation ablation, despite the closure device sealing a hole to divide the left and right atrium. This feature is not present in older devices. To inhibit device erosion, physicians must choose the correct device and exact size.

For the first six months after obtaining a cardiac closure device, the patient should take precautions against endocarditis:

• Inform all their dentists and medical professionals that they have a cardiac closure device. They might want to keep this information on a card they carry.

• If someone has signs of an infection, they should speak to their doctor (sore throat, general body aches, and fever).

• To avoid infections, take proper care of your teeth and gums.

• Frequent dental visits.

• Before undergoing any surgery that could result in bleeding, including dental procedures (even simple teeth cleaning), invasive tests, and most major or minor surgeries, take antibiotics.

• The kind and dosage of antibiotics they should take should be discussed with their doctor.

What Is the Recovery Period After Placing the Cardiac Closure Devices?

After their healthcare professional inserts an ASD closure device with a catheter, they will require an overnight stay. After that, they might have to rest up for two weeks. Then, after a day or two, they can engage in non-strengthening activities. Open-heart surgery requires a lengthier recovery period. If there are complications like chest pain or fainting after placing the cardiac closure devices, immediately report to the physician.

Are Cardiac Closure Devices Safe for an MRI Scan?

After receiving an ASD closure device, they could undergo a magnetic resonance imaging (MRI) scan. However, they might be subject to limitations, such as having their scan performed in a device with a weaker magnetic field. Discuss the individual device's MRI safety with the provider.

Conclusion

The cardiac closure device placement is not life-threatening and is a safe procedure. However, the devices placed during open heart surgery are associated with complications and need a long hospital stay. For the individuals in which the cardiac closure devices cannot be placed, then surgery for closure of the septal defects is advisable. The placement of the devices helps to relieve the severe symptoms.