INTERMEDIATE AND LONG TERM OUTCOME OF PATIENTS AFTER DEVICE CLOSURE OF ASD WITH SPECIAL REFERENCE TO COMPLICATIONS
AbstractBackground: Device closure of Secundum atrial septal defect (ASD) is an accepted mode of treatment inselected patients with a suitable defect. The major initial concern over the long term outcome has beenerosions and more recently development of aortic regurgitation. Objective was to assess the intermediateand long term outcome of patients with device closure of ASD with special reference to complications.Methods: Two hundred and four patients with significant Secundum ASD, 16 months to 55 years(median 8 years) were considered for transcatheter closure with the Amplatzer septal occluder fromOctober 1999 to April 2009 with follow up examinations at 1, 3, 6, and 12 months and thereafter at yearlyinterval. Results: Device closure of ASD was done successfully in 202/204 patients. The immediate (first24-hour) major complications included device embolization (n=4), pericardial effusion (n=1) and 2:1 heartblock (n=1). At a mean follow up of 4.9 years (90 days to 9.6 years, median 5.3 years) complete closurewas documented in all patients. Two patients (1%) had developed mild aortic regurgitation. Atrialfibrillation occurred in 3 adult patients (1.5%) at a mean of 2 weeks post procedure with completerecovery within 6 months. There were no late embolizations, erosions or thromboembolic events on longterm follow up. Conclusions: Device closure of Secundum ASD using Amplatzer septal occluder is safeand effective in intermediate and long term follow up with extremely low mortality rate. The risk ofdevelopment of aortic regurgitation or atrial fibrillation is also very low.Keywords: Atrial septal defect, Device closure, Cardiac catheterisation, Complications
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