Related Experiment Video

Updated: Feb 4, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

4.4K

Atrial septal defect closure: indications and contra-indications

Alain Fraisse1, Monica Latchman1, Shiv-Raj Sharma1

  • 1Royal Brompton & Harefield NHS Foundation Trust, London, UK.

Journal of Thoracic Disease
|October 12, 2018
PubMed

Insights

Transcatheter closure is an alternative for atrial septal defects (ASD), but large or complex cases still face limitations. Further studies are needed to confirm safety and feasibility in challenging scenarios.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Transcatheter closure is a common alternative to surgery for ostium secundum atrial septal defects (ASD).
  • Large ASDs (>38 mm), defects with deficient rims, and complex cases with comorbidities or in small children are often excluded from transcatheter closure.
  • Surgical closure remains the standard for these complex cases.

Purpose of the Study:

  • To provide a comprehensive overview of current indications and contraindications for ASD device closure.
  • To explore the limitations of transcatheter closure in complex and controversial ASD cases.
  • To review current evidence on the feasibility and safety of transcatheter closure in challenging ASD populations.

Main Methods:

  • Review of current literature and cohort studies on transcatheter ASD device closure.
  • Analysis of indications, contraindications, and limitations for device closure.
  • Evaluation of outcomes in complex ASD cases treated with transcatheter techniques.

Main Results:

  • Transcatheter closure is established for standard ASDs, but large defects and those with deficient rims are typically referred for surgery.
  • Transcatheter closure in complex ASDs, including those with comorbidities or in small children, remains controversial.
  • Several studies report successful percutaneous closure in complex cases using current devices and technology.

Conclusions:

  • Current transcatheter techniques show promise for complex ASDs, expanding the possibilities beyond traditional indications.
  • Larger studies and longer follow-up are essential to confirm the feasibility and safety of transcatheter closure in these challenging patient groups.
  • The evolving technology may further broaden the application of transcatheter closure for a wider range of ASDs.

Keywords:
Atrial septal defect (ASD)cardiac catheterisationclosure

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