397 Do elderly patients benefit from transcatheter closure of atrial septal defect?

Abstract

Objective: To evaluate the outcomes of transcatheter closure of secundum atrial septal defect (ASD) using Amplatzer Septal Occluder (ASO) in elderly patients. Material and methods: Consecutive 35 adult pts over 50 years (25 F, 10 M) with a mean age of 61.2±15.9 (50-69) with ASD who underwent transcatheter closure, were analyzed. All patients had an isolated secundum ASD with pulmonary to systemic blood flow ratio, Qp:Qs: 2.56±1.6 (1.5-3.43). Quality of life (QoL) was measured using the SF36 questionnaire (SF36q). SF36q were repeated in all pts before procedure and 6 months of follow-up as well as symptom-limited treadmill exercise tests with respiratory gas exchange analysis (Bruce protocol) and transthoracic color Doppler echocardiographic study. Results: The ASO device was successfully implanted in all pts (procedure time 37.2+/-4.1 (14-51) minutes, fluoroscopy time 10.1+/-7.9 (5-40) minutes). The defect echo diameter was 17.6+/-5.1 (8-32) mm. The diameter of the implanted devices ranged 13-36 mm. After 6 months of ASD closure, all the pts showed a significant improvement of exercise capacity. 7 QoL parameters (except mental health) improved at 6 months follow up compared to their baseline data. The right ventricular dimension decreased in 27 pts (77.1%), the right atrium dimension decreased in 29 pts (82.8%) (Table 1). Conclusions: Transcatheter closure of secundum ASD in elderly patients is a safe and effective procedure, with excellent short-term follow-up results. Closure of ASD in elderly patients caused significant improvement of exercise capacity as well as improvement of quality of life measured by SF36 questionnaire. In six months observation right heart pressure overload signs were diminished in most of the elderly patients.