Know Zero Fluoroscopy to Treat Congenital Heart Disease

JAKARTA - Congenital heart disease (PJB) such as Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) are among the conditions that are often found, both in children and adults.

Globally, the prevalence of PDA is estimated to be 8–10 cases per thousand live births, with the cause not yet known for sure. In Indonesia, this figure is equivalent to around 50,000 babies born with congenital heart defects every year, and VSD ranks first as the type most commonly found in children.

"There is no one cause that can be said to cause congenital heart disease. So it is said that this is multifactorial, there are many factors that can affect," said Specialist Doctor of Heart and Blood Vessels Subspecialist of Pediatric Cardiology and Congenital Heart Disease at Pondok Indah Hospital, dr. Yovi Kurniawati, Sp. J.P, Subsp. K.Ped.P.J.B. (K), during a media meeting in Senayan, Jakarta, on Thursday, May 7, 2026.

VSD itself is a hole in the dividing wall between the two heart chambers (ventricles) and is most often found in childhood. Meanwhile, ASD is a hole in the wall that separates the right and left atria of the heart, which is often diagnosed in adult patients, because it is generally not detected during childhood.

In some cases, small defects or holes in the heart can close spontaneously. However, if they are medium to large in size, ASD and VSD can cause serious complications such as heart failure, pulmonary hypertension, growth and development delays, and risk of heart infection (endocarditis).

Therefore, it is very important to carry out early detection and intervention for closure. For years, the procedure for closing ASDs and VSDs has been performed through open surgery or transcatheter methods with fluoroscopic guidance (X-rays).

Although effective, fluoroscopy has a fundamental weakness, namely repeated radiation exposure, which is quite risky for children and medical personnel. To reduce this risk, there is now a zero fluoroscopy procedure for treating ASD and VSD.

"So actually the radiation, if we are exposed to it continuously, especially in children, it is cumulative. So, that's what we want to avoid," he said.

Zero fluoroscopy ASD and VSD closure is a technique of transcatheter atrial and ventricular septal defect closure without the aid of X-rays at all. Instead, the procedure is guided entirely by real-time echocardiography (e.g., transesophageal echocardiography/TEE or intracardiac echocardiography/ICE).

"This procedure only uses guidance from the echo, not using fluoroscopy. The goal is to reduce the radiation dose we receive, not only for the patient, but also for the doctor," he explained.

The advantages of this procedure are radiation-free, high accuracy, success rate of more than 95 percent with minimal complications, to be friendly to children and adolescents who avoid patients from long-term radiation accumulation.