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Objective. To evaluate the safety and effect of transcatheter device closure in ostium secundum atrial septal defects (ASD II) in patients aged 40 years and older.
Methods. Retrospective single-centre study concerning 47 consecutive ASD transcatheter occlusion procedures performed between January 1999 and December 2008. Electrocardiography, echocardiography and clinical assessments of the patients were conducted pre- and post-intervention and at follow-up.
Results. Of the 130 patients who were referred for interventional ASD closure, 47 were 40 years and older and all of them actually had the device inserted. There were no major complications during the intervention. Mean follow-up time was 15±15 months. During follow-up, three patients needed surgical reintervention because of device embolisation (n=2) or dislocation (n=1). Of the patients with severe right ventricular (RV) dilatation, more than half (58%) had no or mild dilatation at last follow-up. Reduction of RV dilatation was not related to age. Pulmonary hypertension was present in 63% before the procedure and was reduced to 38% at follow-up. NYHA class improved in all age groups, also in patients over 60 years of age. In two of the three patients who died during follow-up, no cause of death could be established, but both had responded well to treatment regarding the echocardiographic and clinical findings.
Conclusion. Transcatheter device closure of ASD is a successful and effective treatment, also for patients aged 40 years and older. Patients showed regression of right ventricular enlargement and an improvement in functional class. (Neth Heart J 2010;18:537–42.)
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Kim JJ, Hijazi ZM. Clinical outcomes and costs of Amplatzer transcatheter closure as compared with surgical closure of ostium secundum atrial septal defects. Med Sci Monit. 2002;8:CR787–RE791. PubMed
Roos-Hesselink JW, Meijboom FJ, Spitaels SE, van Domburg R, van Rijen EH, Utens EM, et al. Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age. A prospective follow-up study of 21–33 years. Eur Heart J. 2003;24:190–197. PubMedCrossRef
Rao PS. When and how should atrial septal defects be closed in adults? J Invasive Cardiol. 2009;21:76–82. PubMed
Yalonetsky S, Lorber A. Percutaneous closure of a secundum atrial septal defect in elderly patients. J Invasive Cardiol. 2007;19:510–512. PubMed
Elshershari H, Cao QL, Hijazi ZM. Transcatheter device closure of atrial septal defects in patients older than 60 years of age: immediate and follow-up results. J Invasive Cardiol. 2008;20:173–176. PubMed
Khairy P, O’Donnell CP, Landzberg MJ. Transcatheter closure versus medical therapy of patent foramen ovale and presumed paradoxical thromboemboli: a systematic review. Ann Intern Med. 2003;139:753–760. PubMed
- Transcatheter device closure of atrial septal defects in patients aged 40 years and older
R. van Domburg
P.P.T de Jaegere
- Bohn Stafleu van Loghum