Immediate and Short-Term Outcome of Percutaneous Trans-Catheter Device Closure of Atrial Septal Defects in Adults

Document Type : Original Article

Authors

Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

10.21608/asmj.2025.361421.1396

Abstract

Background: Atrial septal defect (ASD), one of the most common congenital heart defects, often remains undiagnosed
until adulthood, leading to complications like pulmonary hypertension, arrhythmias, and right ventricular (RV) dysfunction.
Transcatheter ASD closure offers a minimally invasive option.
Aim of the Work: To evaluate the immediate and short-term outcome of transcatheter ASD closure on cardiac functions and
functional capacity in adults.
Methods: This prospective cohort study included 50 adults who underwent transcatheter ASD closure. Patients were stratified
according to age at transcatheter closure into two groups: Group 1 (18–40 years) and Group 2 (>40 years). Comprehensive
pre- and post-procedural assessments included echocardiography, 6-minute walk test (6MWT), and coronary angiography.
Results: Significant reductions in RV end-diastolic volume (75.20 ± 10.30 to 68.18 ± 9.98 mm3, P < 0.001), RV systolic
pressure (49.22 ± 4.85 to 35.14 ± 4.77 mmHg, P < 0.0001), and mean pulmonary artery pressure (28.82 ± 6.43 to 23.86 ± 5.90
mmHg, P < 0.001) were observed at one month. Left ventricular ejection fraction improved significantly (P < 0.001), and
6-minute walk test (6MWT) distance increased (464.38 ± 49.61 to 488.80 ± 44.39 m, P < 0.001). Younger patients exhibited
greater functional capacity improvement (P = 0.008). Pre-procedural mPAP negatively correlated with 6MWT performance
(P < 0.05).
Conclusions: Transcatheter ASD closure significantly improves cardiac remodeling, pulmonary hemodynamics, and functional
capacity, with younger patients benefiting most.

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