Related Experiment Video
Updated: Sep 29, 2025
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Outcomes and complications of percutaneous device closure in adults with secundum atrial septal defect
Faiza Bashir1, Maryam Hameed1, Bashir Hanif2
15th Year MBBS Student, Ziauddin Medical University, Karachi, Pakistan.
Insights
Percutaneous closure of atrial septal defects using the Amplatzer device is safe and effective in adults. This procedure improves symptoms, reduces right ventricular size, and lowers pulmonary arterial pressure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Echocardiography
Background:
- Secundum atrial septal defect (ASD) in adults can lead to significant cardiovascular complications.
- Percutaneous closure offers a less invasive alternative to surgical repair.
Purpose of the Study:
- To evaluate the immediate outcomes and complications of Amplatzer septal occluder device closure for adult secundum ASD.
- To assess long-term changes in right ventricular size, pulmonary arterial systolic pressure, and device embolization incidence.
Main Methods:
- An observational study of 64 adult patients undergoing percutaneous ASD closure with the Amplatzer device.
- Trans-esophageal echocardiography for pre-closure assessment and immediate outcome evaluation; transthoracic echocardiography for follow-up.
- Data collected over a 5-year period (January 2013 - July 2018).
Main Results:
- Immediate procedural success rate was 92.2% (59/64 patients).
- Acute device embolization occurred in 8% (5/64) of cases; no late embolic events were reported.
- At 20-month follow-up, 84.4% of patients reported improved symptoms, 89.5% showed normalized right ventricular size, and a significant reduction in pulmonary arterial systolic pressure was observed (p<0.001).
Conclusions:
- Percutaneous closure of secundum ASD in adults using the Amplatzer septal occluder is a safe and effective treatment.
- The procedure leads to significant clinical improvement, favorable right ventricular remodeling, and reduced pulmonary hypertension at intermediate-term follow-up.
Objective:
To assess immediate outcome and complications of Amplatzer septal occluder percutaneous device for closure of secundum atrial septal defect in adults, and to determine regression in right ventricular size, reduced pulmonary arterial systolic pressure and incidence of device embolization at follow-up.
Methods:
The single-cohort, ambi-directional, observational study was conducted at the Tabba Heart Institute, Karachi, from January 2013 to July 2018, and comprised patients admitted consecutively for percutaneous atrial septal defect closure. Pre-closure trans-oesophageal echocardiogram was performed in all cases to ensure adequacy of defect margins necessary for device stability. Immediate procedure success and complications were determined by trans-oesophageal echocardiogram, while transthoracic echo was done on follow-up. Data was analysed using SPSS 21.
Results:
Of the 64 patients, 41(71.9%) were females. The overall mean age was 36.6±14 years. Median size of atrial septal defect was 21mm (interquartile range: 17-26mm). Immediate success was observed in 59(92.2%) patients, and there were 5(8%) acute device embolization events. Small residual atrial septal defect was found in 4(6.3%) cases. On 20-month follow-up, 54(84.4%) patients showed improved symptoms. Repeat transthoracic echo was performed in 39(60.1%) cases, and there were no late embolic events or residual atrial septal defect. Right ventricular size normalized in 34(89.5%) cases, mean pulmonary arterial systolic pressure reduced significantly compared to pre-closure measurement (p<0.001).
Conclusions:
Percutaneous atrial septal defect closure was found to be safe and effective in adults with secundum atrial septal defect. Timely closure resulted in improved symptoms, right ventricular remodelling and reduced pulmonary arterial systolic pressure at intermediate-term follow-up.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:21Cardiac Catheterization II: Right Heart Catheterization