Related Experiment Video
Updated: Feb 11, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
ASD Closure in Structural Heart Disease
Dominik M Wiktor1, John D Carroll2
1University of Colorado, Anschutz Medical Campus, Mail Stop B132, Leprino Office Building, 12401 East 17th Avenue, Room 524, Aurora, CO, 80045, USA. dominik.wiktor@ucdenver.edu.
Insights
New data show residual iatrogenic atrial septal defects (iASD) after heart interventions can negatively impact outcomes. This review covers iASD closure indications, new devices, and potential long-term complications.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Percutaneous atrial septal defect (ASD) closure is established, but residual iatrogenic ASD (iASD) after left heart interventions is a growing concern.
- Emerging data link residual iASD to poorer clinical outcomes and increased mortality.
- Advancements in left-heart structural interventions necessitate a re-evaluation of iASD management.
Purpose of the Study:
- To review indications for closing iASD following left heart structural interventions.
- To discuss new-generation closure devices for iASD.
- To highlight potential late complications and the need for long-term follow-up.
Main Methods:
- Literature review of recent studies and trials on iASD.
- Analysis of data concerning residual iASD after large-bore transseptal access.
- Evaluation of new closure device technologies and their efficacy.
Main Results:
- Residual iASD is increasingly recognized as a factor affecting clinical outcomes.
- New closure devices show potential advantages in managing iASD.
- Understanding and mitigating late complications of percutaneous ASD closure is crucial.
Conclusions:
- Management of residual iASD is critical in contemporary interventional cardiology.
- Further research is needed to optimize iASD closure strategies and minimize late complications.
- Long-term follow-up is essential for patients with iASD after interventions.
Purpose Of Review:
While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up.
Recent Findings:
With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published. While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.
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