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Publication Date

11-20-2015

Keywords

atrial septal defect, percutaneous closure, right ventricle, echocardiography

Abstract

Background: Percutaneous closure of atrial septal defects has been shown to be a safe alternative to surgery. Despite this, past studies have largely been focused on either small- to medium-sized atrial septal defects or percutaneous closure in children and young adults.

Purpose: Our study sought to examine if right ventricular function and size improved after percutaneous closure of large atrial septal defects in the adult population.

Methods: Over a 5-year span, 25 patients underwent percutaneous closure of a secundum atrial septal defect with an occluder device. A retrospective examination was conducted for each patient, including both echocardiography and chart review for postdevice complications/symptoms.

Results: Average patient age was 44.4 years, and mean device size was 28 mm (range: 24–38 mm). Follow-up echocardiography (mean of 134 days) showed tricuspid annular plane systolic excursion was significantly improved (2.11 vs. 2.33; P = 0.013). There also was a significant reduction in right ventricular diastolic chamber size (31.0 vs. 35.4; P < 0.01). At 1-year postprocedure follow-up, zero patients had experienced transient ischemic attack, stroke or device perforation/embolization.

Conclusion: Percutaneous closure of large secundum atrial septal defects in adults improves right ventricular function as well as right ventricular chamber size. Percutaneous closure of large atrial septal defects also is a safe, very low-risk procedure in terms of future adverse neurologic, embolic or perforation-related events.

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