Percutaneous Closure of Atrial Septal Defects

Abstract

Background-Percutaneous closure of atrial septal defects is well established in children and adults and has been found to improve symptoms and positively influence right-heart remodeling. The aim of this study was to evaluate the efficacy and long-term outcome in adult patients older than 60 years. Methods and Results-The study population comprised 96 patients in the age group of 60 to 84 years. Percutaneous closure was performed effectively in all patients. Functional capacity according to New York Heart Association functional class and peak oxygen uptake (VO 2 max) in the cardiopulmonary exercise testing improved significantly after atrial septal defects closure, especially in patients with a pulmonary-to-systemic flow ratio Ͼ2. Echocardiographic measurements of the right ventricular end-diastolic diameter showed a significant decrease. No device-associated complications were observed, but in 16 patients, paroxysmal atrial fibrillation occurred after device implantation. Conclusions-Percutaneous atrial septal defects closure can be performed safely and with minimal risk even in elderly patients. They profit in terms of symptom reduction, improvement of exercise capacity, and right-heart remodeling.(Circ Cardiovasc Intervent. 2009;2:85-89.)

Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support

“…Similarly, studies of patients with a secundum atrial septal defect, which also results in isolated RV volume overload, have demonstrated that the volume load adversely affects both right and left ventricular geometry and function and that these abnormalities are fully reversible when the shunt is eliminated early in life [32-36]. However, functional recovery is less complete when an atrial septal defect is closed later in life [37-39]. Taken together, these studies show that "isolated" RV volume load can be tolerated with little or no symptoms during the first 3-4 decades of life and elimination of the volume load during that period usually leads to full functional recovery.…”

Atrial Septal Defect Closure in Geriatric Patients

“…Several studies and our own experience have demonstrated clinical benefits and positive right-heart remodeling, with reduction of the right ventricular end-diastolic diameter. (8)(9)(10)(11)(12)(13)(14)(15)(16)(17) However, few studies were published considering geriatric patients, who older than 70 years. (18)(19)(20)(21) In this aged population, not only catheter closure of ASD but also surgical closure has been reported very limited experiences, little data are published on functional results.…”

Successful Percutaneous Device Closure for Giant Atrial Septal Defect with Massive Pericardial Effusion and Pulmonary Hypertension in an Elderly Patient

“…In these cases, closure of an ASD with a large left-to-right shunt can increase left ventricular inflow, leading to left ventricular heart failure [5]. To avoid this catastrophic condition, two diuretics and an inotropic agent were administered intravenously for , and pulmonary-to-systemic blood pressure ratio was 0.87.…”