Transcatheter Closure of Secundum Atrial Septal Defect in Patients Over 60 Years Old.
10.4070/kcj.2013.43.2.110
- Author:
Saet Byul WOO
1
;
So Ick JANG
;
Seong Ho KIM
;
Soo Jin KIM
;
Sang Yun LEE
;
Jae Sook BAEK
;
Woo Sup SHIM
Author Information
1. Department of Pediatrics, Hallym University Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Atrial septal defect;
Septal occluder device;
Elderly
- MeSH:
Adult;
Aged;
Arrhythmias, Cardiac;
Catheterization;
Catheters;
Comorbidity;
Female;
Follow-Up Studies;
Heart Diseases;
Heart Septal Defects, Atrial;
Humans;
Percutaneous Coronary Intervention;
Risk Factors;
Septal Occluder Device;
Stents;
Ventricular Dysfunction, Left
- From:Korean Circulation Journal
2013;43(2):110-114
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Atrial septal defect (ASD) is the one of most common congenital heart diseases detected in adults. Along with remarkable development of device technology, the first treatment strategy of secundum ASD has been transcatheter closure in feasible cases. However, there are only a few publications regarding the results of transcatheter closure of ASD in elderly patients, especially those over 60 years of age. We report our results of transcatheter closure of ASD in patients over 60 years old. SUBJECTS AND METHODS: Between May 2006 and December 2011, 31 patients over 60 years old (25 female and 6 male; mean 66.7+/-5.25 years old, range 61-78 years old) were referred to our center. RESULTS: A total of 23 patients underwent therapeutic catheterization to close secundum ASD, and the closure was successful in 22 patients (95.7%). All patients who underwent the procedure survived except for one patient who expired because of left ventricular dysfunction. A small residual shunt was observed in two (9%) of 21 patients before discharge but disappeared at follow-up. All patients eventually had complete closure. There were five patients who had coronary problems. One patient underwent percutaneous coronary intervention using a stent at the same time as transcatheter closure of ASD. Atrial arrhythmias were detected in 6 of 23 patients (26.1%) before the procedure. One patient was successfully treated by radiofrequency ablation before the procedure. No patients displayed new onset arrhythmia during the follow-up period. Follow-up echocardiographic evaluation showed a significantly improved right ventricular geometry. CONCLUSION: We conclude that transcatheter closure of ASD is a safe and an effective treatment method for patients over 60 years old if the procedure is performed under a thorough evaluation of comorbidities and risk factors.
