Honghiranrueng Lalita, Roymanee Supaporn, Wongwaitaweewong Kanjarut, Jarutach Jirayut, Buntharikpornpun Rujira
Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Front Cardiovasc Med. 2024 Aug 30;11:1448967. doi: 10.3389/fcvm.2024.1448967. eCollection 2024.
Transcatheter atrial septal defect (ASD) closure is the primary approach for treating ASD secundum; however, data on long-term outcomes remain limited. This study aimed to elucidate the prevalence of adverse outcomes following transcatheter ASD closure in a diverse population.
This retrospective cohort study was conducted at the Songklanagarind Hospital and included patients who underwent transcatheter ASD closure between January 2010 and August 2021.
The study included 277 patients who completed follow-up for at least 1 year, with varying ages: <25 years (31%), 25-40 years (19%), 40-60 years (34%), and >60 years (16%). The median follow-up duration was 37 months (interquartile range: 20, 61). The overall mortality rate was 1.8%, and no deaths were attributed to device-related complications. Hospitalization due to heart failure occurred in 0.7% of the cases. Most patients improved or stabilized based on the New York Heart Association functional class. Adverse outcomes included new-onset atrial fibrillation (prevalence: 2.7%) and pulmonary hypertension (prevalence: 0.6%). The resolution of pulmonary hypertension varied among age groups, with 100% resolution in patients <25 years. Multivariate analysis identified male sex, overweight, and history of stroke to be significantly associated with adverse outcomes after transcatheter ASD closure.
Transcatheter ASD closure was safe and effective, with age not being a limiting factor for success. Male sex, being overweight, and a history of stroke were associated with adverse outcomes. These findings contribute to our understanding of the long-term outcomes following ASD closure.
经导管房间隔缺损（ASD）封堵术是治疗继发孔型ASD的主要方法；然而，关于长期预后的数据仍然有限。本研究旨在阐明不同人群经导管ASD封堵术后不良结局的发生率。
本回顾性队列研究在宋卡那卡林医院进行，纳入了2010年1月至2021年8月期间接受经导管ASD封堵术的患者。
该研究纳入了277例完成至少1年随访的患者，年龄各异：<25岁（31%）、25 - 40岁（19%）、40 - 60岁（34%）和>60岁（16%）。中位随访时间为37个月（四分位间距：20, 61）。总死亡率为1.8%，且无死亡归因于器械相关并发症。0.7%的病例因心力衰竭住院。根据纽约心脏协会功能分级，大多数患者病情改善或稳定。不良结局包括新发房颤（发生率：2.7%）和肺动脉高压（发生率：0.6%）。肺动脉高压的缓解情况在不同年龄组有所不同，<25岁的患者缓解率为100%。多因素分析确定男性、超重和卒中史与经导管ASD封堵术后不良结局显著相关。
经导管ASD封堵术安全有效，年龄不是成功的限制因素。男性、超重和卒中史与不良结局相关。这些发现有助于我们理解ASD封堵术后的长期预后。
