Single Centre Experience For Percutaneous Closure Of Secundum Atrial Septal Defect

Abstract

Introduction: Atrial septal defect (ASD) is the most common congenital heart disease in adults and constitutes 5-10% of all congenital heart disease. Primary surgical closure has been the standard approach for many years with high success rate. Transcatheter closure of ASD in selected patients has became the contemprorary practice that has the advantages of short hospital stay and relative ease of prosedure. In this article, we reported the results of percutaneous closure of ASD in our center. Methods: Between 2009-2011, thirty-two patients (mean age 36±18 years and 24 females) who had secundum type ASD which detected by transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were included in this study. Twenty-nine (90,6%) patients were closed percutaneously. Tree patients were referred for surgery because of failure of percutaneous closure. Amplatzer Septal Occluder was used in 25 (86,2%) patients and Occlutech device was used in other patients. All procedures were performed under local anesthesia. All of the patients were examined with TTE before the procedure and, at the 1st, 3rd, 6th and 12th month follow-up visits. Results: Pre-operative mean pulmonary artery pressure was 33,3±7,5 mmHg and mean pulmonary to systemic flow (Qp/Qs) ratio was 2,9±1,1. Mean ASD diameter measured by TEE was 20,1±6,6 mm and mean streched diameter measured by balloon catheter was 22,1±5,9 mm. Mean device size 24±6 mm (range 12-36 mm). In the follow-up period no major complication was observed, but mild to moderate residual shunt flow was detected in two patients (% 6,8). Conclusion: Percutaneous ASD closure has been performed with high success and low complication rates in patients with secundum atrial septal defect in our center