A Comparative Study of Outcomes after Transcatheter Closure of Secundum-Type Atrial Septum Defect in Adults Younger than 60 Years and the Older Ones

Objective : To compare the results of transcatheter atrial septal defect (ASD) closure between adults younger than 60 years and the older ones in terms of the clinical and echocardiographic outcomes. Material and Method : The cohort study consisted of 333 adult patients who underwent device closure of secundum ASD at Central Chest Institute of Thailand between January 2007 and June 2012. They were divided into two groups, group 1 were patients with age younger than 60 years, and group 2 were patients with age equal or older than 60 years. Clinical and echocardiographic outcomes were collected and analyzed. Results : There were 274 patients in group 1 with mean age of 38.7±12.1 years and 59 patients in group 2 with mean age of 66±4.9 years). One year after ASD closure, functional class improvement ≥1 class was observed in both groups but there was no significant difference between group (64% in group 1 vs. 71.4% in group 2, p = 0.308). A decrease in systolic pulmonary arterial pressure (PAP) and right ventricular systolic pressure (RVSP) were observed in both groups. The absolute changes of RVSP at baseline and one year post procedure were not significantly different between groups (15.8±9.9 mmHg in group 1 vs. 12.3±12.2 mmHg in group 2, p = 0.067). Procedural time and minor complications were comparable. Conclusion : Transcatheter ASD closure can be effectively and safely performed in patients older than 60 years as compared with the younger ones. Symptomatic improvement and reduction of PAP and RVSP were observed at any age. ASD closure should be recommended irrespective of symptoms, even in adults with advanced age. Keywords : Transcatheter closure of secundum atrial septum defect, Over 60 years of age, Elderly