Outcome in patients with secundum type atrial septal defect - a single centre experience

This single centre retrospective analysis presents data from 611 patients with ASD closure. Included were patients > 2 years of age. Patients presented at a median [range] age of 6,95 [2 - 86] years for interventional closure of ASD. Out of 611 patients, 215 underwent intracardiac repair based on transthoracic ECHO-findings. Transcatheter device closure was attempted and successfully performed in 300 out of 396 patients (Amplatzer™ Septal-Occluder (ASO) n = 290 patients). Follow –up was 3.3 years [1 day - 21.8 years] in patients with interventional closure of ASD and 0.7 years [3 days – 14.7 years] (p< 0.001; Mann-Whitney) in patients after surgical closure. There was no in-hospital mortality in both groups. One patient after Amplatzer device closure with absent aortic rim developed erosion that was treated by cardiac surgery and patch closure of ASD. Two patients showed dislocation of the device. In 231 out of 396 patients right ventricular dimension normalized completely as determined on last follow-up visit. Six patients at a median age of 60 [49.4 – 68.7] years presented with atrial fibrillation which persisted after ASD closure. 26 patients (6.6%) showed pulmonary hypertension (PH) one of them presenting with coincidental ASD and severe PH. Closure of ASD II can be accomplished safely by interventional catheterization and intracardiac repair. In most cases per-operative transthoracic and transesophageal echocardiography is sufficient to decide whether a surgical approach or interventional closure is the best option to close the defect.