IPG96

Endovascular closure of atrial septal defect (IPG96)

  • Interventional procedures IPG96
  • Issued: October 2004
    • Endovascular closure of atrial septal defect

      The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endovascular closure of atrial septal defect.

      • Description

        An atrial septal defect is the persistence of a hole (the foramen ovale) in the wall (septum) between the right atrium and left atrium of the heart.  The foramen ovale usually closes spontaneously after birth; an atrial septal defect is present when this closure does not occur. In the most common type, an ostium secundum atrial septal defect, the septum between the atria fails to form properly during foetal development, resulting in a permanent hole. An atrial septal defect allows blood to flow from the left atrium to the right atrium, so increasing the flow of blood to the lungs. This is known as a shunt. Patients with atrial septal defects are usually asymptomatic through infancy and childhood. Symptoms such as exertional dyspnoea, fatigue, palpitations and syncope can occur and increasing age carries an increasing risk of stroke. Some patients may develop congestive heart failure.

        Endovascular closure of an atrial septal defect involves making a small incision in the groin to introduce a guidewire and delivery sheath into the femoral vein. An occluder device is then introduced through the delivery sheath on a semi-rigid cable and expanded within the atrial septal defect to close it. Echocardiography and fluoroscopic guidance are used to determine the size and position of the defect and to place the occluder device. A balloon may be used to measure the diameter of the defect. People can usually go home the next day. Small residual shunts after the procedure often resolve as endothelial tissue grows over and around the device. The claimed advantages compared with open surgery are shorter hospital stay, earlier return to normal activities and fewer complications.

      • OPCS4.6 Code(s)

        K13.3 Percutaneous transluminal repair of defect of interatrial septum using prosthesis Y53.- Approach to organ under image control

        Note:  Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

        The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

         

      • Other information

      This page was last updated: 07 January 2014

    • Guidance formats

      Query

Implementation tools and resources

  • None available

Patient

The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.

Quick Reference Guide

The quick reference guide presents recommendations for health professionals

NICE Guidance

The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.

Full Guidance

The published full clinical guidance for specialists with background, evidence, recommendations and methods used.

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.