Transcatheter closure of multiple interatrial communications

Area of Science:

• Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Limited data exists on percutaneous closure of multiple interatrial communications.
• Percutaneous closure is a minimally invasive alternative to surgical repair.

Purpose of the Study:

• To evaluate the acute and midterm outcomes of staged percutaneous closure for multiple interatrial communications.
• To review existing literature on this topic.

Main Methods:

• Retrospective analysis of 148 patients with multiple interatrial communications undergoing percutaneous closure.
• Staged device deployment based on clinical indication after initial closure.
• Categorization of defects by shunt type: left-to-right (LRS) or presumed paradoxical embolism (PPE).

Main Results:

• Complete closure achieved in 67.6% of patients at a mean follow-up of 4.5 years.
• Clinical success (trivial residual shunt) in 86.9% of patients.
• Closure rates increased significantly over time, with 78% complete closure at 24 months post-single device implantation.

Conclusions:

• Staged percutaneous closure of multiple interatrial communications is feasible and safe.
• Spontaneous closure of residual defects is common, supporting a staged approach.
• Staged device delivery may require fewer and smaller devices compared to simultaneous implantation.