Key result
Transcatheter ASD closure resulted in a 19% mean reduction in systolic pulmonary artery pressure in patients ≥60 years compared to 11.3% in those aged 40-59 years at 1 year (P=0.099).
Why the study?
Does transcatheter ASD closure improve pulmonary artery pressure and tricuspid regurgitation in elderly patients compared to younger adults?
Observational (n=46)
Does transcatheter ASD closure improve pulmonary artery pressure and tricuspid regurgitation in elderly patients compared to younger adults?
Absolute Event Rate: 19% vs 11.3%
p-value: p=0.099
Transcatheter ASD closure provides significant hemodynamic improvement in adult patients, with potentially greater benefits in elderly patients despite higher baseline pulmonary artery pressures.
May support greater PAP reduction after ASD closure in elderly patients; leaves open confirmation in randomized data.
OBJECTIVES: Opinions vary widely regarding the effectiveness of transcatheter atrial septal defect (ASD) closure in adults, especially in elderly patients. The purpose of this study was to evaluate and compare the hemodynamic changes after transcatheter ASD closure in two groups of patients, one aged 40-59 years (group 1) and one 60 years of age and older (group 2). METHODS: Retrospective analysis of patient files. RESULTS: Forty-six patients were evaluated (23 in each group). Older patients had a higher prevalence of cardiovascular risk factors and established coronary artery disease. There was no statistically significant difference between the two groups in Qp/Qs values, ASD diameter and occluder size. The elderly patients had significantly higher baseline systolic pulmonary artery pressure (PAp) levels -53 +/- 16.2 vs. 39 +/- 7.7 mm Hg, P = 0.003. One year following the procedure, the mean reduction in PAp values was 11.3% in group 1 and 19% in group 2 (P = 0.099). While significant baseline tricuspid regurgitation (TR) was more frequent in the elderly patients, no significant TR was observed in either group 1 year following the procedure. CONCLUSION: Transcatheter ASD closure resulted in significant hemodynamic improvement in all patients, but was even more beneficial in the elderly patient cohort.
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Yalonetsky et al. (2009) conducted an observational in Atrial septal defect (n=46). Transcatheter ASD closure in patients ≥60 years vs. Transcatheter ASD closure in patients aged 40-59 years was evaluated on Mean reduction in systolic pulmonary artery pressure (PAp) values (p=0.099). Transcatheter ASD closure resulted in a 19% mean reduction in systolic pulmonary artery pressure in patients ≥60 years compared to 11.3% in those aged 40-59 years at 1 year (P=0.099).
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