Comparion between transcatheter and surgical closure of secondum atrial septal defect over 50 years of age / 中国介入心脏病学杂志

ABSTRACT

Objective To compare the safety and recent efficacy between transcatheter and surgical closure of secondum atrial septal defect over 50 years of age. Methods Retrospective analysis was done on 66 patients over 50 years of age who underwent transcatheter (30 cases) and surgical (36 cases) closure of secondum atrial septal defect.The median age was 60.8?7.1 years old in the transcatheter closure group and (57.5?6.3) years old in the surgical closure group( P=0.04).The median sizes of atrial septal defect in the transcatheter and the surgical closure group were 24.9?7.2 mm and 30.4?11.0 mm respectively (P=0.02). We compared the recent efficacy、 complications and prognosis between two groups. Results The instant procedural success rate was 93.3% for the transcatheter closure group and 100% for the surgical group (P=0.85). 2 procedures in the transcatheter closure group failed, 1 patient (2.6%) in the surgical group died during hospitalization and 9 patients (25.0%) underwent Devage tricuspid annuloplasty. Newly onset atrial arrhythmias occurred in 3.3% in the transcatheter closure group and 22.2% in the surgical closure group (P=0.03). After the procedures, right atrial and ventricular dimensions were decreased from 38.0?9.0 mm to 35.2?10.1 mm and from 44.2?8.6 mm to 36.2?9.0 mm in the transcatheter closure group whereas in the surgial group, the atrial and ventricular sizes fell from 44.1?8.2 mm to 38.2?9.5 mm and 49.0?10.2 mm to 37.1?11.0 mm respectively (P