Atrial Septal Defect Device Closure in the Pediatric Population: A Current Review

Abstract

Atrial septal defects are the most common congenital cardiac defects. The natural history of an uncorrected atrial septal defect causes a shortened life expectancy due to right ventricular volume overload and associated congestive heart failure, atrial arrhythmias, and/or pulmonary vascular disease. Surgical closure of the atrial septal defect is a procedure with a long-standing history, and the maturing field of percutaneous closure of atrial septal defects by device implantation has established itself to be a feasible, minimally invasive, and safe procedure. Inherent limitations in device designs have resulted in rare, but serious complications, through subsequent changes in the technical aspects of transcatheter atrial septal defect closure that have minimized the number of patients with an adverse event. Recent Food and Drug Administration re-evaluation of the safety of atrial septal defect closure by device has brought to light some of the acute and long-term issues related to device occlusion. This paper summarizes the history of atrial septal defects, surgical and transcatheter device closure, and the most current outcomes of percutaneous atrial septal defect device occlusion in the pediatric population.