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Updated: Oct 25, 2025

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

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Stroke in patients with secundum atrial septal defect and sequelae after transcatheter closure

Stephen J Dolgner1,2, Zachary Louis Steinberg3, Thomas K Jones3,4

  • 1Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA sjdolgne@texaschildrens.org.

Heart (British Cardiac Society)
|August 12, 2021
PubMed

Insights

In adults with secundum atrial septal defect (ASD), 10% presented with stroke. Obesity, smoking, and Eustachian valve prominence were key risk factors. Post-closure atrial fibrillation (AF) significantly increased stroke risk.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Research

Background:

  • Secundum atrial septal defect (ASD) is a congenital heart condition.
  • Stroke can be a presenting symptom in adults with ASD.
  • Atrial fibrillation (AF) is a known complication after ASD closure.

Purpose of the Study:

  • To determine the frequency and risk factors for stroke in adults with ASD.
  • To assess the rates of AF and stroke after ASD closure.

Main Methods:

  • Retrospective review of adult ASD patients (2002-2018) without prior atrial arrhythmias.
  • Multivariable logistic regression to identify stroke risk factors.
  • Survival analysis to evaluate post-closure stroke, stratified by AF presence.

Main Results:

  • 10% of 346 ASD patients presented with stroke.
  • Independent stroke risk factors: BMI > 25 (OR 18.2), smoking (OR 9.5), prominent Eustachian valve (OR 9.2).
  • Post-closure: 4% developed AF, 1% had stroke; AF strongly predicted post-closure stroke (p<0.001).

Conclusions:

  • Stroke incidence was 10% in this ASD cohort.
  • Obesity, smoking, and Eustachian valve anatomy are significant stroke risk factors.
  • Consider lifestyle changes and potentially ASD closure for high-risk patients.
Abstract

Keywords:
atrial septal defectdevice closurestroke

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