Transcatheter device closure of atrial septal defects in patients aged 40 years and older

Altindag, T.; Roos‐Hesselink, Jolien W.; Cuypers, Judith A.A.E.; Domburg, R van; Jaegere, Peter P.T. de; Meijboom, Folkert J.; Witsenburg, Maarten

doi:10.1007/s12471-010-0830-1

Cited by 23 publications

(25 citation statements)

References 21 publications

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“…These data confirm previously published data [4, 12, 13, 20, 21]. In previous studies, the magnitude and time course of cardiac remodelling did not differ significantly between age groups, but the right ventricle remained larger in older patients [20–24].…”

Section: Discussionsupporting

confidence: 92%

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Latent pulmonary hypertension in atrial septal defect: Dynamic stress echocardiography reveals unapparent pulmonary hypertension and confirms rapid normalisation after ASD closure

Lange

Braun

Schoen³

et al. 2013

Neth Heart J

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ObjectiveClosure of atrial septal defects (ASD) prevents pulmonary hypertension, right heart failure and thromboembolic stroke. The exact timing for ASD closure is controversial.MethodsIn a prospective study to address the question whether unapparent pulmonary hypertension can be revealed prior to right ventricular (RV) remodelling, patients were investigated before and 6, 12, and 24 months after ASD closure using exercise stress echocardiography (ESE) and ergospirometry (n = 24).ResultsAt rest, RV systolic pressure (RVSP) was normal in 58.8 %, slightly elevated in 26.5 %, and moderately elevated in 11.8 %. One patient showed severe pulmonary hypertension. During ESE, all patients with normal RVSP at rest exhibited an increase (25.7 ± 1.2 mmHg vs. 45.3 ± 2.3 mmHg, p < 0.001). After closure the RVSP was lower, both at rest and ESE. RV diameters decreased too. Tricuspid annulus plane systolic excursion (TAPSE) at rest remained lower after closure (24.0 ± 0.9 vs. 22.0 ± 0.9 mm, p < 0.05). TAPSE in ESE was elevated, and stayed stable after closure (30.1 ± 1.8 mm vs. 29.3 ± 1.6 mm). Before closure, RV systolic tissue velocities (sa) at rest were normal and decreased after closure (14.0 ± 1.0 cm/s vs. 11.5 ± 0.7 (6 month) vs. 10.6 ± 0.5 cm/s (12 month), p < 0.05). During ESE, sa velocity was similar before and after closure (23.0 ± 1.3 cm/s vs. 23.3 ± 1.9 cm/s). Maximal oxygen uptake (VO2/kg) did not differ between baseline and follow-ups.ConclusionLatent pulmonary hypertension may become apparent in ESE. ASD closure leads to a significant reduction in this stress-induced pulmonary hypertension and to a decrease in the right heart diameters indicating reverse RV remodelling. RV functional parameters at rest did not improve. The VO2/kg did not change after ASD closure.

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Section: Discussionsupporting

confidence: 92%

“…In patients with larger shunts resulting in pulmonary hypertension, ASD closure resulted in a decline in pulmonary pressures and a reduction in the right ventricular (RV) and right atrial (RA) volumes and sizes [4, 12]. …”

Section: Introductionmentioning

confidence: 99%

Latent pulmonary hypertension in atrial septal defect: Dynamic stress echocardiography reveals unapparent pulmonary hypertension and confirms rapid normalisation after ASD closure

Lange

Braun

Schoen³

et al. 2013

Neth Heart J

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show abstract

“…2015;10:E48-E53 erature that RV volumes rapidly decrease immediately following ASD closure. 1,[29][30][31][32][33] This should allow for the LV cavity to conform to a more conventional geometric shape following device closure. This rapid conformational change might allow for the LV to better accommodate the increased pressures due to shunt closure.…”

mentioning

confidence: 99%

Left Ventricular Hemodynamic Changes and Clinical Outcomes after Transcatheter Atrial Septal Defect Closure in Adults

et al. 2014

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“…Decrease in symptom (breathlessness and palpitation) and improved functional class after device closure was observed in many studies. 3,[12][13][14][15] Khan et al reported that significant improvement in functional class and echocardiographic parameters as early as 6 weeks post device closure. There was correlation of functional class and 6-min walk test.…”

Section: Discussionmentioning

confidence: 99%

“…The reduction in pulmonary artery pressure was observed in multiple studies in elderly. [13][14][15] One of the most discussed subjects regarding closing an ASD in the elderly is the impact on AF. Several studies find no or onlyvery little effect on the development of AF when treated late in life.…”

Section: Discussionmentioning

confidence: 99%

ASD device closure in elderly adults

Adhikari¹,

Dhungel²,

Bogati³

et al. 2019

Asian J Med Sci

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Background: Closure of ASDs in elderly patients caused significant clinical and hemodynamic improvement after device closure. Aims and Objective: We aim to share our experience of ASD device closure in elderly adults. Materials and Methods: It was a prospective single center study done at Shahid Gangalal National Heart Centre. All elderly patients (>50years) who underwent ASD device closure fromFeb 2016 to July 2018 and completed three months of device closure were prospectively follow up for the symptoms, RA and RV dimension, Tricuspid Regurgitation and Tricuspid Regurgitation pressure gradient (TRPG). Results: During the study period 48 elderly adults underwent successful ASD device closure. Except one patient we could follow up all patients. Among the patient’s 33 were female, Age ranged from 50years to 72years with the mean age of 55 years. Shortness of breath was the most common symptom during presentation. ASD size ranged from 10mm to 33mm with the mean of 23mm. Device size ranged from 14mm to 40mm with the mean of 29mm. Amplatzer septal occluder was used in 47 patients. RA and RV were dilated in all patients. Mild TR was present in 26 patients, Moderate TR in 17 patients, Severe TR in 5 patients. Mean follow-up time was 12 months. Symptoms reduced in all patients expect one. RA and RV size reduced in all patients. Tricuspid regurgitation pressure gradient reduced from mean of 56 mmHg to Mean of 16 mmHg. During the follow up level of tricuspid regurgitation reduced, 11 patients had mild TR, Trace TR in 15 patients. Conclusion: ASD device closure can result in improvement in clinical and hemodynamic in elderly adults.

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Transcatheter device closure of atrial septal defects in patients aged 40 years and older

Cited by 23 publications

References 21 publications

Latent pulmonary hypertension in atrial septal defect: Dynamic stress echocardiography reveals unapparent pulmonary hypertension and confirms rapid normalisation after ASD closure

Latent pulmonary hypertension in atrial septal defect: Dynamic stress echocardiography reveals unapparent pulmonary hypertension and confirms rapid normalisation after ASD closure

Left Ventricular Hemodynamic Changes and Clinical Outcomes after Transcatheter Atrial Septal Defect Closure in Adults

ASD device closure in elderly adults

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