Percutaneous closure of ASD and PFO achieved a procedural success rate of 98.8%, major complication rate of 2.4%, and complete symptom resolution in 82.4% of patients during mean 4.2-year follow-up.
Observational
No
85 adult patients (≥18 years) who underwent transcatheter closure of secundum atrial septal defect (ASD, n=58) or patent foramen ovale (PFO, n=27) at a single center in Saudi Arabia. Mean age 40.8 ± 15.2 years, 67.1% female. Exclusions: primum or sinus venosus ASDs, complex congenital heart disease, surgical closure, and incomplete procedural or follow-up data.
Percutaneous transcatheter closure using devices (predominantly Amplatzer Septal Occluder or Figulla Flex II) performed under general anesthesia with transesophageal echocardiography (TEE) and fluoroscopic guidance.
Composite adverse events (defined as device embolization, cardiac tamponade, new-onset atrial fibrillation, thromboembolic events, device erosion, or need for reintervention) at a mean follow-up of 4.2 ± 2.8 years.composite
Percutaneous transcatheter closure of ASD and PFO is highly successful and safe, providing excellent long-term symptom resolution and prevention of recurrent embolic events.
Background Atrial septal defect (ASD) and patent foramen ovale (PFO) are common interatrial communications with distinct pathophysiology and clinical implications. Percutaneous closure has emerged as the preferred treatment modality. This study evaluates long-term clinical outcomes following transcatheter closure of ASD and PFO. Methodology This retrospective cohort study analyzed 85 patients who underwent percutaneous closure of secundum ASD or PFO at King Abdulaziz Medical City, Jeddah, Saudi Arabia, between 2014 and 2024. Patients were evaluated using transesophageal echocardiography and transthoracic echocardiography. Procedural success, complications, and long-term outcomes were assessed. Results The cohort included 85 patients (mean age = 40.8 ± 15.2 years; 67.1% female). ASD was diagnosed in 58 (68.2%) patients, and PFO in 27 (31.8%) patients. Procedural success rate was 98.8% (84/85 patients). Major complications occurred in 2.4% of cases, including one device embolization requiring surgical retrieval and one case of cardiac tamponade. During a mean follow-up of 4.2 ± 2.8 years, complete symptom resolution was achieved in 82.4% of patients. New-onset atrial fibrillation developed in 3.5% of patients, and residual shunt was detected in 7.1% of cases. No recurrent embolic events were observed in the PFO group. Conclusions Percutaneous closure of ASD and PFO demonstrates high procedural success rates (98.8%) with low major complication rates (2.4%) and excellent long-term outcomes, including symptom resolution in 82.4% of patients. Device-based closure represents a safe and effective therapeutic strategy for appropriately selected patients with interatrial communications.
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Mohammed S Alqarni
Sary Mahmoud Wedinly
Nawaf Alsubhi
Cureus
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Alqarni et al. (Thu,) conducted a observational in Adults (≥18 years) with secundum atrial septal defect (ASD) or patent foramen ovale (PFO) undergoing percutaneous closure (n=85). Percutaneous transcatheter closure of secundum ASD or PFO was evaluated on Procedural success (successful device deployment with no or trivial residual shunt) and major complication rates. Percutaneous closure of ASD and PFO achieved a procedural success rate of 98.8%, major complication rate of 2.4%, and complete symptom resolution in 82.4% of patients during mean 4.2-year follow-up.
www.synapsesocial.com/papers/69abc2455af8044f7a4ebc37 — DOI: https://doi.org/10.7759/cureus.104702