The atrial septal defect diagnosed in the senility – the benefit of the transcatheter closure (RCD code: IV‑2B.1)

Objective: Closure of the atrial septal defect in the elderly patients is controversial. The aim of the study was to evaluate the outcomes of transcatheter closure of secundum atrial septal defect (ASD) in elderly patients. Methods: From a total of 488 patients with ASD who underwent transcatheter closure 15 pts over 70 years (10 females, 5 males) with a mean age of 75.3 ±12.7 (70–79) were analyzed. All patients had an isolated secundum ASD with a mean Qp:Qs: 3.01 ±1.9 (2.6–3.9). A symptom-limited treadmill exercise tests with respiratory gas exchange analysis and transthoracic color Doppler echocardiographic study as well as Quality of life (QoL) measured using the SF36 questionnaire (SF36q) were repeated in all patients before procedure and after 12 months of follow-up. Results: The atrial septal occluder (ASO) device was successfully implanted in all patients (procedure time 29.7±6.5 (14–59) minutes, fluoroscopy time 13.2 ±9.3(6–40) minutes). There were no major complications. The defect echo diameter was 21.7± 15.8 (18–33) mm. The diameter of the implanted devices ranged 20 – 36 mm. After 12 months of ASD closure, all the patients showed a significant improvement of exercise capacity parameters. Seven QoL parameters (except mental health) improved at 12 months follow up compared to their baseline data. The right ventricular dimension decreased (p<0.005), parameters of exercise capacity improved – oxygen consumption increased (p<0.001). Conclusions: Closure of ASD in elderly patients caused a significant clinical and hemodynamic improvement after percutaneous treatment, which is maintained to long-term follow-up what justified this procedure in old age. JRCD 2015; 2 (5): 144–149