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Original Articles

Percutaneous Closure of Atrial Septal Defects

Echocardiographic and Functional Results in Patients Older Than 60 Years

Smita Jategaonkar, MD; Werner Scholtz, MD; Henning Schmidt, MD and Dieter Horstkotte, MD, PhD, FESC

From the Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.

Correspondence to Werner Scholtz, MD, Heart and Diabetes Center North Rhine-Westphalia, Department of Cardiology, Georgstr. 11, D-32545 Bad Oeynhausen, Germany. E-mail akohlstaedt{at}hdz-nrw.de

Received March 26, 2008; accepted February 11, 2009.

Background— Percutaneous closure of atrial septal defects is well established in children and adults and has been found to improve symptoms and positively influence right-heart remodeling. The aim of this study was to evaluate the efficacy and long-term outcome in adult patients older than 60 years.

Methods and Results— The study population comprised 96 patients in the age group of 60 to 84 years. Percutaneous closure was performed effectively in all patients. Functional capacity according to New York Heart Association functional class and peak oxygen uptake (VO₂max) in the cardiopulmonary exercise testing improved significantly after atrial septal defects closure, especially in patients with a pulmonary-to-systemic flow ratio >2. Echocardiographic measurements of the right ventricular end-diastolic diameter showed a significant decrease. No device-associated complications were observed, but in 16 patients, paroxysmal atrial fibrillation occurred after device implantation.

Conclusions— Percutaneous atrial septal defects closure can be performed safely and with minimal risk even in elderly patients. They profit in terms of symptom reduction, improvement of exercise capacity, and right-heart remodeling.

Key Words: atrial septal defect • left-to-right shunt • interventional closure • elderly patients • exercise capacity • atrial fibrillation

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CLINICAL PERSPECTIVE

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This article has been cited by other articles:

				G. Martucci and M. Landzberg Not Just Big Kids: Closing Atrial Septal Defects in Adults Older Than 60 Years Circ Cardiovasc Interv, April 1, 2009; 2(2): 83 - 84. [Full Text] [PDF]