EARLY AND MIDTERM OUTCOME OF TRANS CATHETER DEVICE CLOSURE OF SECUNDUM ATRIAL SEPTAL DEFECT-SINGLE CENTER EXPERIENCE

Dr. El Tayeb Ahmed MD*, Dr. Salim Ahmad FCPS, FRCP

Trans-catheter atrial septal defect (ASD) closure is becoming mainstay of therapy for secundum type ASD for the past few decades. Aims: This research evaluated the early and mid-term outcome of trans-catheter device closure for secundum atrial septal defect. Methods: Retrospective single center study from January 1997 to December 2019. All patients who underwent trans-catheter closure of secundum atrial septal defect during the study period were included. Those patients with incomplete data were excluded. The Patients files were checked, Gender, age at intervention, defect size, procedure duration, and early and midterm follow-up results were collected, All statistical analysis tests were performed using IBM SPSS version 25 (IBM crop, Armonk, N.Y.). Results: A total of 385 patients were included, 44% males; median age: 8 years (3-65), 77.7% children less than 18 years age, mean ASD defect diameter as measured by Trans Esophageal Echocardiography (TEE) was 16.2 ± 6 mm. Successful closure of ASD was achieved in all patients. Early complication: device embolized in 2 patients after 24 hour, 29 patients had small residual shunt ,8 of them closed within 2 years follow up, two patients have pericardial effusion Twelve (3.1%) patients had mitral valve regurgitation (MR) before ASD device closure. After a median 4 years follow-up, 9 (2.3%) patients had no change in severity of MR (mild plus to moderate MR), 3 patient improved from moderate to mild MR. Six (1.6%) patients had moderate tricuspid regurgitation (TR) preprocedure and at the last follow-up 2 (0.5) patients improved to mild TR. Late complication: one patient has device embolization after 18 months, one patient has atrial fibrillation No death, cardiac erosion, decreased left ventricular function or thromboembolism recorded. Conclusion: Trans catheter closure of secundum atrial septal defect is safe in children and adults. It has a favorable early and mid-term outcome in our study, especially no death or major complications. Regular follow up for monitoring complication is crucial