INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

CLOSURE OF ATRIAL SEPTAL DEFECT

Gülay Uzun

Health Sciences University, Ahi Evren Thoracic Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Trabzon, Türkiye

Uzun G. Closure of Atrial Septal Defect In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.421-436.

ABSTRACT

Atrial septal defects (ASD) are characterized by the incomplete closure of the septum between the right and left atrium and are one of the most common congenital heart diseases in adults. Transesophageal echocardiography (TOE) is the most accurate method for evaluating the disease and is the most important step in making a decision for surgical or percutaneous closure in addition to its diagnosis. ASDs that are hemodynamically significant, i.e. Qp/QS above 1.5 or accompanied by right ventricular volume overload, should be closed. Secundum ASD closure with a transvenous percutaneous device, which was first applied by Mills and King in 1974, has become increasingly widespread and has become the first-line treatment option in patients with suitable morphology.

With the development of the transcatheter approach, percutaneous transcatheter ASD closure has become an alternative treatment to surgery. In recent years, thanks to significant advances in device technology and procedural techniques, transcatheter closure of ASD has become the preferred treatment method for most patients with secundum ASD. The sufficient flexibility, recapture and repositioning features of new generation devices have made the procedure easier to perform and safer. Today, there are clear principles in the management of ASDs regarding patient selection, pre-procedure evaluation, step-by-step details of the procedure and post-procedure follow-up. In this article, we will discuss transcatheter closure of ASD.

Keywords: Atrial septal defect; Secundum type atrial septal defect

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