Feasibility of atrial septal defect type II occluders determined by computed tomography virtual cardioscope

This study aims to assess the suitability of large ASD type II occluders by evaluating the locations of the ASD and its extensions, as well as the adequacy of the rim, through the utilization of CT virtual cardioscopy.

Atrial septal defects (ASDs) represent the most frequent congenital heart abnormalities observed in adults and the second most prevalent in infants. There has been a notable paradigm shift over the past four decades which percutaneous transcatheter closure as the preferred treatment modality over traditional surgical method.

We conducted a retrospective descriptive study on patients with type II ASD who undergone transcatheter and surgical closure from January 2007 to April 2023. Rigorous exclusion criteria were applied to ensure a homogeneous study population and enhance the validity of research findings. All MDCT measurements were performed independently in a blinded manner. Statistical analysis was performed using independent T-test and Chi-square.

A total of 24 patients were evaluated by virtual cardioscope. Eighteen patients underwent successful occlusion therapy for ASD without complications. Six patients underwent surgery to close the interatrial defect. Patients who undergone transcatheter approach were older than patients in the surgical group. There were no differences between the 2 groups in regard to long axis and short axis in MDCT (all p > 0.05). The rimless angle in the operation group is larger than the operation group and there were differences between the 2 groups (p < 0,05). Location and extension of the defect did not have significant association in determining treatment procedure.

Accurate morphological assessment play a crucial role in assessing the suitability of either a percutaneous approach or surgical correction for atrial septal defects (ASD).