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Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

Published on: June 15, 2015

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Transcatheter Versus Surgical Closure of Atrial Septal Defect in Children and Adults: A Systematic Review and

Johnson Kannady1, Putri Amelia2, Ahmad Dwi Rifa'i1

  • 1Center of Evidence Based in Pediatric Cardiology, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia.

Anatolian Journal of Cardiology
|January 15, 2026
PubMed

Insights

Transcatheter closure of atrial septal defects shows high success rates with fewer complications and faster recovery compared to surgery. This approach is particularly beneficial for suitable patients, supporting personalized treatment decisions.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Pediatric Cardiology

Background:

  • Atrial septal defect (ASD) closure can be achieved surgically or via transcatheter intervention.
  • Comparative outcomes between pediatric and adult populations undergoing ASD closure remain inconsistent.
  • This review synthesizes evidence to evaluate procedural success, complications, and characteristics of both closure methods across age groups.

Purpose of the Study:

  • To compare the procedural success, complication rates, and recovery times of surgical versus transcatheter closure for atrial septal defects.
  • To evaluate outcomes across different age groups (children and adults).
  • To synthesize observational evidence for informed clinical decision-making in ASD management.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
  • Inclusion of 36 observational studies published up to 2024, with quality assessed by the Newcastle-Ottawa Scale.
  • Random effects models and subgroup analyses by age and procedure type were employed; publication bias was assessed.

Main Results:

  • Pooled procedural success rate for ASD closure was high at 95%.
  • Transcatheter closure demonstrated higher success in children (87%) compared to surgery (99%), while success rates were comparable in adults (97% vs 98%).
  • Transcatheter intervention resulted in significantly shorter hospitalizations (mean difference: -3.86 days) and fewer major complications (RR: 0.58) compared to surgery.

Conclusions:

  • Both surgical and transcatheter approaches offer high success rates for ASD closure.
  • Transcatheter intervention is associated with lower complication rates and faster recovery, especially in anatomically suitable patients.
  • Treatment selection should be individualized based on patient age, specific anatomy, and available institutional expertise.
Abstract

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