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March 7, 2026Cureus0 citationsOpen Access

Clinical Outcomes of Atrial Septal Defect and Patent Foramen Ovale After Percutaneous Closure: A 10-Year Retrospective Analysis

MAMohammed S AlqarniSWSary Mahmoud WedinlyNANawaf Alsubhi

Key Result

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.

Key Points

  • This study aims to evaluate the long-term clinical outcomes following percutaneous closure of ASD and PFO.
  • Retrospective cohort study of 85 patients from King Abdulaziz Medical City.
  • Patients underwent echocardiographic evaluations.
  • Assessment of procedural success, complications, and long-term outcomes.
  • 98.8% procedural success rate with 84 out of 85 patients.
  • Major complications occurred in 2.4% of cases.
  • 82.4% of patients achieved complete symptom resolution during follow-up.
  • New-onset atrial fibrillation developed in 3.5% of patients.
  • No recurrent embolic events were observed in the PFO group.

Study Design

Type

Observational (n=85)

Multicenter

No

Structured PICO

P
Population
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.
I
Intervention
Percutaneous transcatheter closure using devices (predominantly Amplatzer Septal Occluder or Figulla Flex II) performed under general anesthesia with transesophageal echocardiography (TEE) and fluoroscopic guidance.
O
Outcome
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.

Limitations

  • Retrospective design
  • Single-center study limiting generalizability
  • Small sample size limiting power for rare outcomes
  • No control group for direct comparison to medical or surgical management
  • Variable follow-up duration and potential loss to follow-up
  • Temporal bias due to evolving device technology and techniques over 10 years
  • Single-center experience
  • Small sample size
  • Absence of a control group
  • Variability in follow-up duration
  • 10-year study period introducing temporal bias

Abstract

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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Cite This Study

Alqarni et al. (2026) conducted an 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.

synapsesocial.com/papers/69abc2455af8044f7a4ebc37https://doi.org/10.7759/cureus.104702
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