BACKGROUND AND OBJECTIVES: With the exception of bicuspid aortic valves, atrial septal defects (ASDs) are the most common congenital heart lesions found in adults. A mortality and morbidity benefit has clearly been demonstrated in the treatment of this lesion in younger patients. However, the benefits of ASD closure are less well defined in the elderly. We report our experience with transcatheter ASD closure and detail its impact on functional status and right ventricular remodeling as indicators of right heart failure in patients greater than 60 years of age. SUBJECTS AND METHODS: Fifty-five patients (median age 70 years) underwent ASD closure at a single center during an eight-year period. Data were collected and analyzed retrospectively. RESULTS: Transcatheter closure was successful in all patients. No major complications occurred during the periprocedural or follow-up periods. Complete defect closure was documented in 97% of patients during follow-up. All patients improved by at least one New York Heart Association (NYHA) functional class. Following ASD closure, no patient was in NYHA III or IV. The median right-ventricular end-diastolic diameter decreased from 39 mm to 26.6 mm (p<0.001). CONCLUSION: Atrial septal defect closure is safe and effective in elderly patients. Our data and prior published data consistently demonstrate that even patients greater than 60 years of age experience improvement in functional status and right ventricular remodeling. Therefore, patient age should not influence the decision of whether an ASD should be closed.
Adult ; Aged ; Aortic Valve ; Bicuspid ; Follow-Up Studies ; Heart ; Heart Failure ; Heart Septal Defects, Atrial ; Humans ; New York ; Retrospective Studies ; Ventricular Remodeling

Cardiac Surgical Procedures ; instrumentation ; methods ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Infant ; Male ; Treatment Outcome

Coarctation of the aorta (CoA) is a common form of congenital heart disease. Adult patients with CoA may be asymptomatic or may present with hypertension. Over the last few years, endovascular management of adult patients with CoA emerged as the preferred strategy. Stent implantation, though technically challenging, offers the best and most lasting therapy. In this paper, we will review technical considerations and outcome of patients undergoing stent implantation for CoA.
Adult ; Angioplasty, Balloon ; Aortic Coarctation ; Cardiac Catheterization ; Heart Defects, Congenital ; Humans ; Hypertension ; Stents

Coarctation of the aorta (CoA) is a common form of congenital heart disease. Adult patients with CoA may be asymptomatic or may present with hypertension. Over the last few years, endovascular management of adult patients with CoA emerged as the preferred strategy. Stent implantation, though technically challenging, offers the best and most lasting therapy. In this paper, we will review technical considerations and outcome of patients undergoing stent implantation for CoA.