Comparing the impact of transcatheter ASD closure on echocardiographic indices in adults below and above 50 years.

Abstract

Background: Transcatheter device closure is the method of choice for the closure of secundum atrial septal defects (ASD) with appropriate anatomic characteristics, leading to symptomatic relief, increased survival rates, cardiac remodeling, and improved cardiac function.

Objective: Assessing the impact of transcatheter ASD closure on echocardiographic indices and comparing them between individuals younger and older than 50.

Method: In this retrospective cohort study, 240 patients with isolated secundum ASD and complete documentation and follow-up data who underwent transcatheter device closure between 2015 and 2019 were included. Demographic, peri-procedural, and echocardiographic findings were compared before and after the procedure and among two age groups.

Results: A total of 240 patients (68% female, 44% younger than 50) with a median age of 51 underwent transcatheter ASD closure. ASD closure led to a significant decline in the size of four cardiac chambers and systolic pulmonary arterial pressure (SPAP), in addition to a significant improvement in biventricular systolic function, LV diastolic function, and valvular insufficiencies. Although patients aged 50 and older had worse LV diastolic and RV systolic function, in addition to larger RV size and bi-atrial dimensions at the baseline, the extent of improvement of these parameters among them was significantly more pronounced than those younger than 50. There were no significant differences in the extent of the decline in SPAP between the two groups.

Conclusion: Transcatheter ASD device closure is a beneficial procedure with high success rates and low complication rates among older individuals, eventually leading to improvements in cardiac form and function.