A number of structural defects that once required opening the chest can now be closed with a device delivered through a vein in the leg. The patient is usually home the following day.
Which defects can be closed this way
Atrial septal defects, between the upper chambers, are the most commonly treated. Some ventricular septal defects and patent ductus arteriosus are also suitable, as are certain other communications. Suitability depends on the size of the defect, its position, and whether there is enough surrounding tissue rim to seat the device securely.
Assessment before closure
A transesophageal echocardiogram defines the anatomy precisely — size, position, rims and any additional defects. Pressures in the lungs are assessed, because significantly raised pulmonary pressure can change or preclude the decision to close.
The procedure and afterwards
A catheter is passed from a vein in the groin to the heart, the device is positioned across the defect under imaging guidance, and released once its position is confirmed. Antiplatelet therapy follows for a defined period while the body’s own tissue grows over the device. Follow-up echocardiography confirms position and complete closure.
Adults diagnosed late
Atrial septal defects are frequently found in adulthood, sometimes after decades of vague breathlessness or an incidental abnormal ECG. Closure in adults can still improve symptoms and reduce the risk of atrial arrhythmia, though the benefit depends on age, pulmonary pressures and the size of the shunt.
Written and medically reviewed by Dr. Gurbir Singh Gill — Interventional Cardiologist & Diabetologist, Oxford Hospital.
Last reviewed: 1 September 2026