Comparing Clinical Efficacy and Quality of Life Between Transesophageal Echocardiography-Guided and X-Ray Guided Percutaneous Occlusion in Adults With Secundum Atrial Septal Defect.

Aim: This study aims to compare the clinical efficacy and quality of life between transesophageal echocardiography (TEE)-guided and X-ray-guided percutaneous closure in adults with secundum atrial septal defect (ASD).

Methods: A retrospective cohort study was conducted on 130 adults with secundum ASD who underwent percutaneous closure in our hospital between January 2022 and January 2024. The patients were divided into an observation group (TEE-guided, n = 58) and a control group (X-ray-guided, n = 72). The patients were followed up for 12 months, and their baseline characteristics, operation success rate, ventricular function parameters, postoperative complications and the 36-Item Short Form Health Survey (SF-36) quality of life scores were comparatively analyzed.

Results: Compared to the control group, the observation group had shorter procedure times, higher rates of successful primary closure, shorter hospital stays, and lower early residual postoperative diversion rates (p < 0.05). There were no significant differences in baseline right ventricular end-diastolic volume index (RVEDVi), right ventricular end-systolic volume index (RVESVi), right ventricular ejection fraction (RVEF), left ventricular end-diastolic volume index (LVEDVi), left ventricular end-systolic volume index (LVESVi), and left ventricular ejection fraction (LVEF) between the two groups (p > 0.05). However, 3 months after surgery, both groups showed improvement in biventricular function, with the observation group exhibiting better right ventricular functional parameters (RVEDVi, RVESVi, RVEF) than the control group (p < 0.05). Furthermore, the overall complication rate was significantly lower in the observation group than in the control group (p < 0.05). There was no significant difference in pre-procedure SF-36 scores between the two groups (p > 0.05); however, 12 months after surgery, SF-36 scores in all domains increased in both groups, with the observation group scoring higher (p < 0.05).

Conclusions: In treating adult secundum ASD, TEE-guided percutaneous ASD closure yields superior clinical outcomes compared to the X-ray-guided method regarding procedural efficiency, reduction of early residual shunts, recovery of right ventricular function, relief of complication, and improvement in quality of life.