Comparative Changes of Pulmonary Artery Pressure Values and Tricuspid Valve Regurgitation Following Transcatheter Atrial Septal Defect Closure in Adults and the Elderly

Abstract

Opinions vary widely regarding the effectiveness of transcatheter atrial septal defect (ASD) closure in adults, especially in elderly patients. The purpose of this study was to evaluate and compare the hemodynamic changes after transcatheter ASD closure in two groups of patients, one aged 40-59 years (group 1) and one 60 years of age and older (group 2). Retrospective analysis of patient files. Forty-six patients were evaluated (23 in each group). Older patients had a higher prevalence of cardiovascular risk factors and established coronary artery disease. There was no statistically significant difference between the two groups in Qp/Qs values, ASD diameter and occluder size. The elderly patients had significantly higher baseline systolic pulmonary artery pressure (PAp) levels -53 +/- 16.2 vs. 39 +/- 7.7 mm Hg, P = 0.003. One year following the procedure, the mean reduction in PAp values was 11.3% in group 1 and 19% in group 2 (P = 0.099). While significant baseline tricuspid regurgitation (TR) was more frequent in the elderly patients, no significant TR was observed in either group 1 year following the procedure. Transcatheter ASD closure resulted in significant hemodynamic improvement in all patients, but was even more beneficial in the elderly patient cohort.