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Updated: Jun 13, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Long-term outcomes of transcatheter atrial septal defect closure: a single-center retrospective study
Lalita Honghiranrueng1,2, Supaporn Roymanee2, Kanjarut Wongwaitaweewong2
1Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
Insights
Transcatheter atrial septal defect (ASD) closure is safe and effective. Adverse outcomes were linked to male sex, being overweight, and stroke history, not age.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Transcatheter atrial septal defect (ASD) closure is the standard treatment for secundum ASD.
- Long-term outcome data for transcatheter ASD closure are limited.
- Understanding adverse event prevalence is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of adverse outcomes after transcatheter ASD closure.
- To evaluate the safety and efficacy of transcatheter ASD closure in a diverse patient population.
- To identify factors associated with adverse outcomes.
Main Methods:
- Retrospective cohort study.
- Inclusion of 277 patients undergoing transcatheter ASD closure between 2010 and 2021.
- Minimum 1-year follow-up with median of 37 months.
Main Results:
- Overall mortality was 1.8%, with no device-related deaths.
- Heart failure hospitalization occurred in 0.7% of patients.
- New-onset atrial fibrillation (2.7%) and pulmonary hypertension (0.6%) were key adverse outcomes. Male sex, overweight status, and prior stroke were associated with adverse events.
Conclusions:
- Transcatheter ASD closure is a safe and effective procedure.
- Age is not a barrier to successful ASD closure.
- Risk factors for adverse outcomes include male sex, overweight, and stroke history.
Background:
Transcatheter atrial septal defect (ASD) closure is the primary approach for treating ASD secundum; however, data on long-term outcomes remain limited. This study aimed to elucidate the prevalence of adverse outcomes following transcatheter ASD closure in a diverse population.
Methods:
This retrospective cohort study was conducted at the Songklanagarind Hospital and included patients who underwent transcatheter ASD closure between January 2010 and August 2021.
Results:
The study included 277 patients who completed follow-up for at least 1 year, with varying ages: <25 years (31%), 25-40 years (19%), 40-60 years (34%), and >60 years (16%). The median follow-up duration was 37 months (interquartile range: 20, 61). The overall mortality rate was 1.8%, and no deaths were attributed to device-related complications. Hospitalization due to heart failure occurred in 0.7% of the cases. Most patients improved or stabilized based on the New York Heart Association functional class. Adverse outcomes included new-onset atrial fibrillation (prevalence: 2.7%) and pulmonary hypertension (prevalence: 0.6%). The resolution of pulmonary hypertension varied among age groups, with 100% resolution in patients <25 years. Multivariate analysis identified male sex, overweight, and history of stroke to be significantly associated with adverse outcomes after transcatheter ASD closure.
Conclusion:
Transcatheter ASD closure was safe and effective, with age not being a limiting factor for success. Male sex, being overweight, and a history of stroke were associated with adverse outcomes. These findings contribute to our understanding of the long-term outcomes following ASD closure.
