An Encouraging Approach to Complex ASDs: A Multicenter Study
Rasit Aktas1, Nazmi Narin2, Kaan Yildiz3
1Department of Pediatric Cardiology, Health Sciences University Izmir Tepecik Education And Research Hospital, Izmir, TR 35020, Turkey. rasitaktas1989@outlook.com.
Pediatric Cardiology
|November 21, 2025
Summary
Transcatheter closure of complex atrial septal defects (ASDs) is effective and safe, even in challenging cases like large defects or rim deficiencies. This minimally invasive approach achieved a high success rate with few complications in experienced centers.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Percutaneous closure is common for atrial septal defects (ASDs).
- Surgery may be preferred for complex ASDs (large defects, rim issues, aneurysms, multifenestration, young age/weight).
- Complex ASDs present unique challenges for transcatheter closure.
Purpose of the Study:
- To evaluate the safety and efficacy of transcatheter closure for complex ASDs.
- To assess success and complication rates in a cohort with challenging anatomical features.
Main Methods:
- Retrospective analysis of 51 patients with complex ASDs undergoing transcatheter closure (Jan 2021 - Aug 2024).
- Data collected included patient demographics, defect characteristics (size, rim, septum), and procedural outcomes.
- Complexities included multifenestrated/multiple defects, aneurysmal septum, young age, large defects, and various rim deficiencies.
Main Results:
- The study included 51 patients with diverse complex ASD features.
- Two device embolizations occurred; otherwise, no complications were reported.
- The overall success rate for transcatheter closure was 96.08%.
Conclusions:
- Transcatheter closure is a safe and effective option for complex ASDs.
- Low complication rates and high success are achievable in experienced centers.
- Minimally invasive closure is feasible even with challenging anatomical variations.
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