Document Detail

Transcatheter device closure of atrial septal defects in patients above age 60.
MedLine Citation:
PMID:  23705553     Owner:  NLM     Status:  In-Process    
BACKGROUND: Closure of an atrial septal defect (ASD) mostly causes reverse remodelling of the right heart, a decrease in pulmonary artery pressures (PASP), and improves functional capacity. However, abolition of the left-to-right shunt may be unfavourable in older patients. This study aimed at evaluating patients older than 60 years who underwent ASD closure.
METHODS AND RESULTS: Forty-seven patients (mean age 69 5 years, 19.1% male) with ASD type secundum who underwent transcatheter device closure were included. Echocardiographic data before and after closure were obtained. Follow-up data until the last follow-up visit were retrieved. Age-, gender- and BMI-matched controls were selected. Before closure, ASD patients had a higher right ventricular end-diastolic diameter (RVEDD), right (RA) and left atrial (LA) dimensions, and PASP when compared to controls. After closure, RVEDD and PASP decreased whereas LVEDD and E/A-ratio increased. RVEDD, PASP, LA dimensions, left ventricular ejection fraction (LVEF) and E/A-ratio were higher than controls. NYHA class improved significantly after ASD-closure. During a median follow-up time of 3.3 years, 6 patients died and 16 were hospitalized because of cardiac events.
CONCLUSION: Device closure in the elderly improved functional capacity, with a decrease, but not a normalization of RV dimensions and PASP, and an increase in LV dimensions, EF and mitral E/A-ratio. Atrial arrhythmias and coronary ischaemic events are common in this population.
Erwin Ströker; Alexander Van De Bruaene; Pieter De Meester; Kristien Van Deyck; Marc Gewillig; Werner Budts
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta cardiologica     Volume:  68     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-05-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  127-32     Citation Subset:  IM    
Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
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