Catheter closure of atrial septal defect in the elderly (≥ 65 years). A worthwhile procedure

Research output: Contribution to journalArticle

Abstract

Background Secundum atrial septal defect (ASD2) is one of the most common cardiac malformations diagnosed in adult life. Catheter closure has made treatment possible even in patients of high age. However, published outcome data for elderly patients is limited. The aim of this study was to report, on a national basis, the long-term outcome of ASD2 catheter closure in the elderly. Material and results We report the clinical and echocardiographic outcome of catheter closure of ASD2 in 148 patients aged 65-87 years. Data was obtained from a national registry, medical records and a questionnaire. The proportion of patients in NYHA I increased from 34% to 61% (p < 0.001) one year after closure and remained stable at the latest follow-up 4,4 (SD 2,6) years post-closure. The proportion of patients with moderate/severe enlargement of the right ventricle and atrium fell from 77% and 76% to 25% and 40%, respectively, (p < 0.001) and right ventricular systolic pressure dropped significantly. Improvement of NYHA class was associated with reduced right ventricular systolic pressure but not with remodelling of the right heart. NYHA deteriorated in 9 patients, despite reduced right ventricular size. Overall, the prevalence of atrial fibrillation was unchanged after closure. Major complication rate was 2% and there was no procedure- or device-related mortality. Conclusion Catheter closure of ASD2 in the elderly is a worthwhile procedure since it improves symptoms and has a low complication rate. However, a subset of patients do not improve, in which we suggest that concealed left ventricular dysfunction may play a causative role.

Details

Authors
  • Maria Thilén
  • Christina Christersson
  • Mikael Dellborg
  • Eva Mattsson
  • Aleksandra Trzebiatowska-Krzynska
  • Ulf Thilén
Organisations
External organisations
  • Halmstad County Hospital
  • Uppsala University
  • Sahlgrenska University Hospital
  • Karolinska University Hospital
  • Linköping University Hospital
  • Skåne University Hospital
  • University of Gothenburg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Adult congenital heart disease, Atrial septal defect, Catheter closure, Elderly, SWEDCON
Original languageEnglish
Pages (from-to)25-30
Number of pages6
JournalInternational Journal of Cardiology
Volume218
Publication statusPublished - 2016 Sep 1
Publication categoryResearch
Peer-reviewedYes