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Current Trends in Device and Size Selection for Transcatheter Atrial Septal Defect Closure in Adults - Insights From
Akihito Tanaka1, Mitsuyoshi Takahara2, Shun Kohsaka3
1Department of Cardiology, Nagoya University Graduate School of Medicine.
Insights
Transcatheter atrial septal defect (ASD) closure trends in adults show device selection and size impact outcomes. Device migration occurred rarely, irrespective of sizing, highlighting procedural safety in transcatheter ASD closure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Investigates current trends in transcatheter atrial septal defect (ASD) closure for adult patients.
- Focuses on device and size selection, and acute complications.
- Utilizes data from the Japanese Structural Heart Disease (J-SHD) registry.
Purpose of the Study:
- To analyze trends in transcatheter atrial septal defect (ASD) closure in adults.
- To examine device and size selection strategies.
- To report on acute complications associated with the procedure.
Main Methods:
- Prospective nationwide multicenter registry analysis.
- Inclusion of 1,921 adult patients undergoing transcatheter ASD closure (2019-2022).
- Assessment of device type, size selection, and acute complications.
Main Results:
- Mean age of participants was 57±18 years; 37.6% were male.
- Aortic rim deficiency present in 50.3% of patients.
- Device migration occurred in 0.4% of patients, unrelated to sizing.
Conclusions:
- Reports trends in clinical features, device/size selection, and acute complications for adult transcatheter ASD closure.
- Highlights device-specific prevalence of aortic rim deficiency.
- Indicates low incidence of device migration regardless of sizing.
Background:
This study investigated current trends in transcatheter atrial septal defect (ASD) closure among adult patients, with an emphasis on device and size selection, as well as acute complications.
Methods And Results:
This study used the Japanese Structural Heart Disease (J-SHD) registry database, which is a prospective nationwide multicenter registry. In all, 1,921 patients who underwent transcatheter ASD closure between 2019 and 2022 were analyzed in this study. The specifics of the procedures, including device type, size selection, and acute complications, were assessed. The mean (±SD) age of participants was 57±18 years, with 37.6% being male. Aortic rim deficiency was observed in most patients (50.3%). The prevalence of aortic rim deficiency was 32.5% for the Amplatzer®Septal Occluder (ASO), 65.6% for the Occlutech®Figulla Flex II Septal Occluder (FSO), and 57.8% for the GORE®CARDIOFORM ASD Occluder. In patients in whom the ASO or FSO was used, device size was 2-3 and 5-6 mm larger than defect size, respectively. Device migration was observed in 8 (0.4%) patients, and occurred regardless of device oversizing or undersizing relative to defect size.
Conclusions:
This study reports the trends in clinical features, device and size selection, and acute complications in adult patients who underwent transcatheter ASD closure.
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