Percutaneous Closure of Intracardiac Defects in Adults: State of the Art

The number of adults with congenital heart disease is expected to increase over the next decade. Although acquired defects are being increasingly recognized in adults, congenital heart disease remains the most common etiology. With advances in cardiac imaging, device technology, and transcatheter techniques, percutaneous closure is now feasible and safe for most intracardiac defects. Device closure is considered the first-line therapy for a variety of congenital intracardiac defects, including ostium secundum atrial septal defects and muscular ventricular septal defects. Percutaneous closure may prevent recurrent cerebrovascular events after a cryptogenic stroke in high-risk patients with patent foramen ovale. It is also an alternative therapeutic option for patients with acquired defects such as posttraumatic or postinfarction ventricular septal defects and paravalvular regurgitation associated with prosthetic valves. Complications after device closure are uncommon, and may be avoided with appropriate patient and device selection. This is a comprehensive review of the current transcatheter management of the most common intracardiac defects encountered in the adult population.