Kiani Reza, Firoozbakhsh Parisa, Dokhani Negar, Alizadehasl Azin, Bakhshandeh Hooman, Firouzi Ata, Zahedmehr Ali, Daneshzadeh Mahnaz
Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Echo Res Pract. 2025 May 5;12(1):10. doi: 10.1186/s44156-025-00074-3.
Transcatheter device closure is the method of choice for the closure of secundum atrial septal defects (ASD) with appropriate anatomic characteristics, leading to symptomatic relief, increased survival rates, cardiac remodeling, and improved cardiac function.
Assessing the impact of transcatheter ASD closure on echocardiographic indices and comparing them between individuals younger and older than 50.
In this retrospective cohort study, 240 patients with isolated secundum ASD and complete documentation and follow-up data who underwent transcatheter device closure between 2015 and 2019 were included. Demographic, peri-procedural, and echocardiographic findings were compared before and after the procedure and among two age groups.
A total of 240 patients (68% female, 44% younger than 50) with a median age of 51 underwent transcatheter ASD closure. ASD closure led to a significant decline in the size of four cardiac chambers and systolic pulmonary arterial pressure (SPAP), in addition to a significant improvement in biventricular systolic function, LV diastolic function, and valvular insufficiencies. Although patients aged 50 and older had worse LV diastolic and RV systolic function, in addition to larger RV size and bi-atrial dimensions at the baseline, the extent of improvement of these parameters among them was significantly more pronounced than those younger than 50. There were no significant differences in the extent of the decline in SPAP between the two groups.
Transcatheter ASD device closure is a beneficial procedure with high success rates and low complication rates among older individuals, eventually leading to improvements in cardiac form and function.
经导管装置封堵术是治疗具有合适解剖特征的继发孔型房间隔缺损（ASD）的首选方法，可缓解症状、提高生存率、促进心脏重塑并改善心脏功能。
评估经导管ASD封堵术对超声心动图指标的影响，并比较50岁及以上和50岁以下个体之间的差异。
在这项回顾性队列研究中，纳入了2015年至2019年间接受经导管装置封堵术且有完整记录和随访数据的240例孤立性继发孔型ASD患者。比较手术前后以及两个年龄组之间的人口统计学、围手术期和超声心动图检查结果。
共有240例患者（68%为女性，44%年龄小于50岁）接受了经导管ASD封堵术，中位年龄为51岁。ASD封堵导致四个心腔大小和收缩期肺动脉压（SPAP）显著下降，同时双心室收缩功能、左心室舒张功能和瓣膜反流也有显著改善。尽管50岁及以上患者的左心室舒张功能和右心室收缩功能较差，且基线时右心室大小和双房尺寸较大，但他们这些参数的改善程度明显比50岁以下患者更显著。两组之间SPAP下降程度无显著差异。
经导管ASD装置封堵术是一种有益的手术，在老年个体中成功率高、并发症发生率低，最终可改善心脏形态和功能。
