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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

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Effects of Transcatheter Atrial Septal Defect Closure in Elderly Patients with Long-Standing Persistent Atrial

Yuki Matsubara1, Michiyo Yamano1, Tetsuhiro Yamano1

  • 1Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.

International Heart Journal
|October 1, 2025
PubMed

Insights

Transcatheter atrial septal defect (ASD) closure effectively treats heart failure in elderly patients with atrial fibrillation (AF). The procedure improved cardiac function and symptoms, even in those with long-standing persistent AF.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Transcatheter atrial septal defect (ASD) closure is established for elderly patients.
  • Outcomes in elderly patients with long-standing persistent atrial fibrillation (AF) after ASD closure require further investigation.
  • Cardiac remodeling and symptom progression in this specific cohort are not fully understood.

Purpose of the Study:

  • To compare cardiac remodeling and symptom improvement after transcatheter ASD closure in elderly patients with AF (AF-ASD) versus those in sinus rhythm (SR-ASD).
  • To elucidate the long-term effects of ASD closure on cardiac structure and function in elderly patients with AF.

Main Methods:

  • Retrospective analysis of 52 patients (>70 years) who underwent transcatheter ASD closure.
  • Serial echocardiograms, NYHA functional classification, and plasma BNP levels were assessed from baseline to 1 year post-procedure.
  • Comparison between patients with AF and those in SR.

Main Results:

  • Significant reverse remodeling of right-sided chambers occurred in both groups up to 1 year.
  • Left atrial volume increased significantly more in the AF-ASD group compared to the SR-ASD group.
  • NYHA functional class improved in both groups, and plasma BNP levels decreased significantly in the AF-ASD group.

Conclusions:

  • Transcatheter ASD closure is effective for heart failure in elderly patients with ASD and long-standing persistent AF.
  • The procedure promotes favorable cardiac remodeling and symptom improvement in this population.
  • Left atrial remodeling differs between AF and SR patients post-closure.

Keywords:
Adult congenital heart diseaseCardiac remodelingHeart failureIntervention

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