How Your Doctor Will Implant the AMPLATZER Septal Occluder

What to expect during and after the procedure will vary. Discuss any questions or concerns you have with your doctor.

1. The procedure will be performed in a heart catheterization laboratory, or "cath lab." You will lie on an X-ray table, and an X-ray camera will take pictures in your chest during the procedure. The staff will monitor heart function by attaching several small, sticky patches to the chest.

2. The doctor will give an anesthetic. It may be general or local. This will depend on the technique the doctor uses to place the device. There should not be significant discomfort.

3. The doctor will use some form of ultrasound imaging equipment in order to see the heart during the procedure. An imaging probe may be placed in the mouth and moved down into the esophagus. This allows the doctor to see the heart up close with an echocardiography machine. Some doctors use an ultrasound machine that places the probe through a vein or artery. Ask your doctor which form will be used.

4. The doctor will insert a catheter through a vein, and move it through one of the body's largest veins until it reaches your heart. Usually the femoral vein is used to access the heart, but the brachial or jugular vein may be used in some circumstances (see figure below).

5. The doctor will perform a diagnostic imaging procedure (angiogram) to visualize the heart and the defect. The doctor will then measure the pressure and oxygen content in different chambers of the heart and measure the size of the ASD using a specially designed balloon.

6. The appropriate size AMPLATZER device is screwed onto a cable, put into a special catheter and advanced through the heart and across the atrial septal defect. The doctor will then push the device out of the catheter until the discs of the device sit on each side of the defect (see figure below).

7. The doctor carefully studies the device's position in your heart. When your doctor is satisfied with the device position, the device is released by unscrewing the cable that was used to slide it through the catheter. The AMPLATZER Septal Occluder is now implanted in your heart.

8. The catheter and imaging probe (if used) are removed and the procedure is completed. The procedure should take approximately 1-2 hours. The procedure is less invasive than open-heart surgery. Many patients have the procedure done in the morning and go home the following morning.

What To Expect After The Procedure

After recovery from anesthesia the patient should be able to sit up and walk about. If there are no complications, the patient may be able to go home that day, or if the doctor prefers, stay overnight in the hospital. Before leaving the hospital, a chest X-ray and/or echocardiogram will be performed to make sure the device is still positioned properly.

Because the procedure is less invasive than open-heart surgery, recovery should be easier. There may be an adhesive bandage where the catheter was inserted. Patients also may have a minor sore throat if an imaging probe was used.

Before leaving the hospital, the doctor will give guidelines for activities and medications. The doctor should tell when the patient can resume normal daily activities.

Medications will be an important part of post-procedure treatment. The doctor will prescribe drugs to take at home. The drugs should prevent blood clots from forming. Notify the doctor if medications cause unpleasant reactions, but do not stop taking them unless instructed to do so. The doctor may be able to prescribe new medications.

Aspirin will be required every day for the next 6 months. Antibiotics will also be required for prevention of heart infection ( endocarditis prophylaxis ) for certain medical procedures like dental work performed after the Occluder placement. Ask the doctor which procedures require you to take endocarditis prophylaxis. The decision to continue taking aspirin and endocarditis prophylaxis beyond 6 months is at the discretion of the doctor.

It is important to keep all follow-up appointments that are scheduled.