Clinical Evaluation Of Transcatheter Closure Of Secundum Atrial Septal Defect In Patients Over 40 Years Of Age

Objective This study sought to compare the safety and efficacy of transcatheter closure of secundum atrial septal defect (ASD) with surgical closure in patients over 40 years of age. Methods A single center, nonrandomized concurrent study was performed in 233 consecutive adults from January, 2004 to December, 2005. The patients were assigned to either the device or surgical closure group according to the patients'option. Baseline physical exams and echocardiography were performed before procedure and at follow up (1, 3, 6 and 12 months for device group, at discharge for surgical group). Results A total of 137 patients were in the group undergoing device closure, whereas 96 patients were in the surgical group. There were no differences in age, sex distribution or baseline cardiac function between the two groups. The age was 49.2±7.7 years for the device group and 47.7 ± 6.6 years for the surgical group (P =0.135). In the device group, 4 (2.9%) patients had multiple ASD, in the surgical group, 5 (5.2%) had multiple ASD. The size of the ASD was 18.9±5.4 mm for the device group and 24.9 ± 6.8 mm for the surgical group (P <0.001). The technical success rate was 97.1% for the device group and 100% for the surgical group (P =0.151). There were 39 cases (40.6%) received simultaneous tricuspid valvoplasty. The residual shunt rate was 0.7% for the device group and 0% for the surgical group (P =0.583). Mortality was zero for both groups. The complication rate was 16.1% for the device group and 30.2% for the surgical group (P =0.015).The amount of blood transfusion was 273.1±491.5 ml for the surgical group and 0 ml for the device group (P <0.001). The length of hospital stay was 4.6 ±...