Percutaneous Closure of Secundum Atrial Septal Defects in Pediatric and Adult Patients: Short-, and Mid-Term Follow-Up Results

Abstract

Objectives: We aimed to evaluate the shortand mid-term results of patients with atrial septal defect (ASD) who were treated with percutaneous closure. Study design: Seventy-nine patients with a diagnosis of secundum ASD (54 female and 25 male; mean age 26.2+/-17.2; range 3 to 71] years) were included in this study. All patients were evaluated by transthoracic (TTE) and/or transesophageal echocardiography (TEE). Amplatzer septal occluder (ASO) was used for percutaneous closure in all patients. In 76 patients, the procedure was performed under local anesthesia with TTE, while in the other 3 patients, it was performed with general anesthesia under the guidance of TEE. Patients were followed up at the 1st, 3rd, 6th and 12th months and annually thereafter. Mean followup period was 13.6+/-6.6 months. Results: Mean diameter of ASDs was 18.2+/-7.5 mm and stretched diameter was 20.7+/-8.04 mm during balloon dilatation, and mean diameter of implanted devices was 22.7+/-8.5 mm. Procedural time was 40.2+/-12.6, and fluoroscopy time was 10.9+/-4.1 minutes. The procedure was successfully performed in all patients (100%). One patient with cardiac tamponade died seven days after cardiac surgery. In two patients, the implanted devices embolized to the pulmonary circulation. Residual flow was found in three patients immediately after the procedure, without residual shunts one month after closure. Mild pericardial effusion in one patient and significant residual shunt due to device malposition in another were discovered at 1 and 6 months of the postprocedural follow- up period, respectively. Conclusion: Our findings showed that percutaneous closure of ASDs is successful in most patients with a low complication rate, and demonstrated that residual shunts do not develop in the majority of patients in the shortand mid- term.