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Background: Device closure of an atrial septal defect(ASD) results in symptom-reduction, right heart remodelling and lower pulmonary artery pressures. However it is unclear if there is a chronological limit to these benefits and whether device closure is safe in elderly subjects. The aim of this study was, therefore, to assess the safety and efficacy of device closure in patients > 60 years. Methods: Retrospective study of Amplatzer Septal OccluderTM device closures from a single institution(May 1999- August 2002). Results: Fifty subjects aged > 60 years(range 60-85 years) had ASD device closure(27% of the total cohort). Defect size and shunt size were similar for both younger and older groups(2.2: 1 in both groups, p=0.9) as were procedural duration, fluoroscopy time and device size deployed. Baseline right ventricular(RV) systolic pressure((younger vs. older) 39 vs. 49 mmHg, p< 0.001) and right ventricular size(45 vs. 51 mm, p< 0.001) were greater in the older group. Following closure RV systolic pressure(49 vs. 45 mmHg, p< 0.01) and RV size(51 vs. 44 mm, p=0.01) decreased in the older group. Conclusion: Device closure of an ASD can be performed safely in older patients. The right heart shows signs of remodelling even in elderly subjects.
Background: Device closure of an atrial septal defect (ASD) results in symptom-reduction, right heart remodeling and lower pulmonary artery pressures. However it is unclear if there is a chronological limit to these benefits and whether device closure is safe in elderly subjects. The aim of this study was, therefore, to assess the safety and efficacy of device closure in patients> 60 years. Results: Fifty subjects aged> 60 years (range 60-85 years) had ASD device closure (27% of the total cohort). Defect size and shunt size were similar for both younger and older groups (2.2: 1 in both groups, p = 0.9) as Baseline right ventricular (RV) systolic pressure ((younger vs. older) 39 vs. 49 mmHg, p <0.001) and right ventricular size (45 vs. 51 mm, pO.001 ) more greater in the older group. Following closur The RV closure was significantly less in the older group. Conclusions: Device closure of an ASD can be performed safely in older patients. The right heart shows signs of remodeling even in elderly subjects.