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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Atrial septal defect closure with left ventricular dysfunction

Victor-Xavier Tadros1, Anita W Asgar

  • 1Interventional Cardiology, Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, QC, Canada.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|May 14, 2016
PubMed

Insights

Transcatheter closure of atrial septal defects (ASD) is standard, but carries risks in adults with left ventricular dysfunction. This review covers managing ASD closure in these patients to minimize complications.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Atrial septal defects (ASD) are common adult congenital heart diseases, often causing left-to-right shunts.
  • Undiagnosed ASDs can lead to significant hemodynamic changes and symptoms in adulthood.
  • Transcatheter ASD closure is preferred, but carries risks in patients with left ventricular (LV) dysfunction due to pressure changes.

Purpose of the Study:

  • To review clinical aspects of transcatheter ASD closure in adults with LV dysfunction.
  • To discuss risk evaluation methods for these complex patients.
  • To outline strategies for minimizing complications during ASD closure.

Main Methods:

  • Review of current literature on transcatheter ASD closure.
  • Analysis of hemodynamic implications in patients with LV dysfunction.
  • Discussion of risk stratification and management strategies.

Main Results:

  • Transcatheter ASD closure in LV dysfunction requires careful patient selection and monitoring.
  • Acute hemodynamic shifts can precipitate complications in vulnerable patients.
  • Pre-procedural risk assessment and tailored closure strategies are crucial.

Conclusions:

  • Transcatheter ASD closure is feasible in select patients with LV dysfunction.
  • Minimizing complications involves comprehensive risk assessment and individualized management.
  • Further research may refine optimal strategies for this patient population.

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