Document Detail


The impact of transcatheter atrial septal defect closure in the older population: a prospective study.
MedLine Citation:
PMID:  20298984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to prove that device closure of atrial septal defect (ASD) in older patients not only improves cardiac function but also results in symptomatic relief by improving functional class.
BACKGROUND: Atrial septal defect accounts for approximately 10% of all congenital cardiac defects. It is possible that ASD closure in older patients may derive benefits, though this is not well established. We therefore aim to prospectively assess the clinical status and functional class of older patients after transcatheter ASD closure.
METHODS: This was a prospective study of all patients age 40 years or more who underwent device closure of a secundum ASD between April 2004 and August 2006. Investigations including atrial and brain natriuretic peptide levels, electrocardiography, chest X-ray, transthoracic echocardiogram, 6-min walk test, and quality of life questionnaire were performed before and at 6 weeks and 1 year after the procedure.
RESULTS: Twenty-three patients (median age 70 years, 13 women) had transcatheter device closure of ASD. Median ASD size was 18 mm (range 9 to 30 mm). Median pulmonary artery pressure was 22 mm Hg (range 12 to 27 mm Hg). At 1 year, New York Heart Association functional class improved (p = 0.004) in 16 patients with significant improvement in 6-min walk-test distance (p = 0.004) and physical (p = 0.002) as well as mental health score (p = 0.03). There were no major complications. One year following closure there was a significant change in left ventricular end-diastolic (p = 0.001) and end-systolic dimensions (p = 0.001) and also significant reduction in right ventricular end-diastolic dimension (p < 0.001).
CONCLUSIONS: Our data demonstrated that ASD closure at advanced age results in favorable cardiac remodeling and improvement of functional class.
Authors:
Arif Anis Khan; Ju-Le Tan; W Li; Kostas Dimopoulos; Mark S Spence; Pak Chow; Michael J Mullen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-19     Completed Date:  2010-06-17     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  276-81     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation.. Published by Elsevier Inc. All rights reserved.
Affiliation:
Adult Congenital Heart Disease Unit, Cardiology Department, Royal Brompton Hospital, Sydney Street, London, United Kingdom. Arif.Khan@rbh.nthames.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Atrial Natriuretic Factor / blood
Biological Markers / blood
Echocardiography, Doppler, Pulsed
Electrocardiography
Exercise Test
Exercise Tolerance
Feasibility Studies
Female
Heart Catheterization* / adverse effects,  instrumentation
Heart Septal Defects, Atrial / diagnosis,  physiopathology,  therapy*
Hemodynamics
Humans
Linear Models
Logistic Models
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Prospective Studies
Quality of Life
Questionnaires
Recovery of Function
Risk Assessment
Risk Factors
Septal Occluder Device
Time Factors
Treatment Outcome
Ventricular Function, Left
Ventricular Function, Right
Ventricular Remodeling
Walking
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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