Transcatheter closure of atrial septal communication: Impact on quality of life in mid-term follow-up

Abstract

Background. Atrial septal defect (ASD) and patent foramen ovale (PFO) are specific types of atrial septal communications (ASC). Objectives. We aimed to assess quality of life (QoL) in patients before and after percutaneous closure of ASC and determine the factors influencing QoL in this group of patients. Material and methods. We performed a clinical assessment and conducted an SF-36 questionnaire, electrocardiography and echocardiography studies in patients before and 6 months after percutaneous ASC closure. Results. Patients with ASD (n = 56) had a lower SF-36 total score than those with PFO (n = 73), before and after percutaneous ASC occlusion (both p < 0.001). After the procedure, the improvement of SF-36 total score in patients with ASD or atrial fibrillation was greater (p < 0.001 and p = 0.005, respectively). We observed correlations between improvement of QoL and baseline supraventricular extrasystolic beats (r s = 0.28; p = 0.002), but not ventricular extrasystolic beats (r s = 0.03; p = 0.76). Quality of life improvement was predicted in patients with ASD by higher baseline tricuspid annular plane systolic excursion (TAPSE) and right ventricular longitudinal dimension R 2 = 0.38; p < 0.001. However, in patients with PFO, this was predicted by TAPSE, lack of arterial hypertension and usage of angiotensin-converting enzyme inhibitors, R 2 = 0.30; p < 0.001. Conclusions. Patients with ASD have lower QoL than those with PFO before and after percutaneous ASC occlusion. Six months after the procedure, the improvement of QoL in patients with ASD was higher than in those with PFO. The change in QoL self-assessed by patients after the procedure was associated with episodes of arrhythmia and was predicted with echocardiographic and clinical parameters.

Cost-effectiveness analysis of patent foramen ovale closure versus medical therapy alone after cryptogenic stroke

“…Results reported by Evola S [ 18 ] indicated a reasonable association with improvement of migraines, due to a reduction in the frequency and severity of migraine attacks. Lelakowska M [ 19 ] also reported that the utility score value of the SF-36 total score was markedly higher 6 months after PFO closure compared with pre-PFO closure.…”