Transcatheter device closure of atrial septal defects in the elderly: technical considerations and short-term outcomes

Int J Cardiol. 2006 Feb 15;107(2):207-10. doi: 10.1016/j.ijcard.2005.03.027.


Background: Device closure of an atrial septal defect (ASD) results in symptom-reduction, right heart remodelling and lower pulmonary artery pressures. However it is unclear if there is a chronological limit to these benefits and whether device closure is safe in elderly subjects. The aim of this study was, therefore, to assess the safety and efficacy of device closure in patients >60 years.

Methods: Retrospective study of Amplatzer Septal Occluder device closures from a single institution (May 1999-August 2002).

Results: Fifty subjects aged >60 years (range 60-85 years) had ASD device closure (27% of the total cohort). Defect size and shunt size were similar for both younger and older groups (2.2:1 in both groups, p=0.9) as were procedural duration, fluoroscopy time and device size deployed. Baseline right ventricular (RV) systolic pressure ((younger vs. older) 39 vs. 49 mmHg, p<0.001) and right ventricular size (45 vs. 51 mm, p<0.001) were greater in the older group. Following closure RV systolic pressure (49 vs. 45 mmHg, p<0.01) and RV size (51 vs. 44 mm, p=0.01) decreased in the older group.

Conclusion: Device closure of an ASD can be performed safely in older patients. The right heart shows signs of remodelling even in elderly subjects.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Balloon Occlusion / adverse effects
  • Balloon Occlusion / instrumentation
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Comorbidity
  • Device Removal
  • Equipment Design
  • Equipment Safety
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Atrial / physiopathology
  • Heart Septal Defects, Atrial / therapy*
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Wedge Pressure
  • Research Design
  • Retrospective Studies
  • Systole
  • Time Factors
  • Treatment Outcome
  • Ventricular Pressure
  • Ventricular Remodeling