Best Paediatric Cardiologists for ASD Closure Surgery in India

An atrial septal defect (ASD) is a congenital opening in the interatrial septum — the muscular wall between the heart's two upper chambers — that allows oxygenated and deoxygenated blood to mix. ASDs vary considerably in size, anatomical type (such as secundum, primum, or sinus venosus), and clinical significance.

Many children and adults with a small-to-moderate ASD have no obvious symptoms for years, while those with larger defects may experience fatigue, reduced exercise tolerance, frequent respiratory infections, or — in adults — palpitations and shortness of breath reflecting progressive right heart changes. Paradoxical embolism, where a clot passes through the defect and reaches the arterial circulation, is a recognised though less common complication that can present as stroke or TIA. Experiencing any of these symptoms does not confirm an ASD, and symptoms alone are not sufficient to establish a diagnosis or determine treatment.

Diagnosis typically begins with a clinical examination, during which a cardiac murmur or fixed splitting of the second heart sound may be detected, followed by an echocardiogram (transthoracic or, where needed, transoesophageal) to visualise the defect, measure its size, assess the direction and volume of the shunt (commonly expressed as the Qp:Qs ratio), and evaluate right heart dimensions. Additional investigations such as cardiac MRI, chest X-ray, ECG, or cardiac catheterisation may be used to quantify pulmonary pressures and vascular resistance, particularly when pulmonary hypertension is suspected. The overall haemodynamic significance of the defect — not size alone — guides management decisions, and these must be interpreted by a qualified clinician in the context of the individual patient's full clinical picture.

Treatment decisions are guided by defect size, the degree of left-to-right shunting, the presence of symptoms, right heart remodelling, and the patient's age and overall health; not every ASD requires active intervention. For haemodynamically significant defects, closure is generally recommended and can be achieved either by a minimally invasive transcatheter approach — where a closure device is delivered via a catheter through a vein — or by open-heart surgery, with the appropriate method depending on the defect's anatomical type and size. A paediatric or adult congenital cardiologist will determine which approach is most suitable based on a thorough individual assessment.

Small ASDs, particularly the secundum type in young children, are often monitored conservatively with regular echocardiographic follow-up, as spontaneous closure can occur in the first few years of life. Where closure is not immediately indicated, or while monitoring is ongoing, a cardiologist may recommend medications to manage associated symptoms such as arrhythmias or, in selected cases, anticoagulation to reduce embolic risk. However, medications do not close the defect itself, and patients with haemodynamically significant ASDs will ultimately be evaluated for a procedural or surgical approach.

ASD Closure Surgery may be considered only when it is appropriate for the confirmed diagnosis and the expected benefit outweighs the individual risks. The decision may depend on symptom severity, investigation results, previous treatment, overall health and the patient's goals. A specialist should discuss alternatives and recovery before any procedure is planned.

ASD is typically evaluated and managed by a paediatric cardiologist in children, or by an adult congenital heart disease (ACHD) cardiologist in adolescents and adults; interventional cardiologists and paediatric or congenital cardiac surgeons are involved when a procedural or surgical closure is planned. Close collaboration between these specialists, together with cardiac imaging experts, is standard in centres experienced with congenital heart disease.

When comparing providers, consider the centre's documented experience with both transcatheter and surgical ASD closure, its access to dedicated congenital cardiac imaging and cardiac catheterisation facilities, and the availability of a multidisciplinary congenital heart team that can provide structured long-term follow-up, particularly important given that patients may require monitoring into adulthood.

Share a concise medical summary, symptom timeline, previous diagnoses, investigation and imaging reports, procedure or biopsy reports where relevant, current medicines, allergies and related treatment records. Provide clear copies with translations when needed. The reviewing doctor may request additional information before giving an opinion.

Our care coordination team can review the initial information, help identify suitable doctors and hospitals, request a medical opinion where available, explain next steps and indicative cost information, and support practical planning before travel. A remote opinion does not replace an in-person examination or emergency care.