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Updated: Aug 13, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter device closure of atrial septal defects in the elderly: technical considerations and short-term
1Toronto Congenital Cardiac Centre for Adults, Division of Cardiology, Toronto General Hospital, University Health Network, Canada. lornaswan@yahoo.com
Insights
Device closure for atrial septal defects (ASD) is safe and effective in patients over 60. This procedure leads to significant right heart remodeling and improved outcomes in elderly individuals.
Area of Science:
- Cardiology
- Interventional Cardiology
- Adult Congenital Heart Disease
Background:
- Atrial septal defect (ASD) device closure offers symptom relief, right heart remodeling, and reduced pulmonary artery pressures.
- The safety and efficacy of device closure in elderly patients (over 60) remain under investigation.
- This study assesses the outcomes of device closure in older individuals with ASD.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous device closure for atrial septal defects (ASD) in patients aged 60 years and older.
- To determine if elderly patients experience similar benefits to younger cohorts following ASD device closure.
- To investigate the impact of ASD device closure on right heart remodeling in the elderly population.
Main Methods:
- Retrospective analysis of Amplatzer Septal Occluder device closures performed between May 1999 and August 2002.
- Inclusion criteria: patients aged >60 years undergoing ASD device closure.
- Comparison of procedural characteristics and outcomes between elderly (>60) and younger patient groups.
Main Results:
- Fifty elderly patients (>60 years) underwent ASD device closure, representing 27% of the total cohort.
- Baseline right ventricular (RV) systolic pressure and size were significantly higher in the older group compared to younger patients.
- Following device closure, elderly patients showed a significant decrease in RV systolic pressure and RV size, indicating positive remodeling.
Conclusions:
- Percutaneous device closure of atrial septal defects (ASD) is a safe and effective option for patients over 60 years of age.
- The right heart demonstrates significant remodeling in response to ASD device closure, even in elderly individuals.
- These findings support the consideration of device closure for ASD in older patient populations.
Background:
Device closure of an atrial septal defect (ASD) results in symptom-reduction, right heart remodelling and lower pulmonary artery pressures. However it is unclear if there is a chronological limit to these benefits and whether device closure is safe in elderly subjects. The aim of this study was, therefore, to assess the safety and efficacy of device closure in patients >60 years.
Methods:
Retrospective study of Amplatzer Septal Occluder device closures from a single institution (May 1999-August 2002).
Results:
Fifty subjects aged >60 years (range 60-85 years) had ASD device closure (27% of the total cohort). Defect size and shunt size were similar for both younger and older groups (2.2:1 in both groups, p=0.9) as were procedural duration, fluoroscopy time and device size deployed. Baseline right ventricular (RV) systolic pressure ((younger vs. older) 39 vs. 49 mmHg, p<0.001) and right ventricular size (45 vs. 51 mm, p<0.001) were greater in the older group. Following closure RV systolic pressure (49 vs. 45 mmHg, p<0.01) and RV size (51 vs. 44 mm, p=0.01) decreased in the older group.
Conclusion:
Device closure of an ASD can be performed safely in older patients. The right heart shows signs of remodelling even in elderly subjects.
