title: Percutaneous transcatheter closure of interatrial septal defect in adults: procedural outcome and long-term results.
abstract: BACKGROUND
  Percutaneous transcatheter closure of patent foramen ovale (PFO) and atrial septal defect (ASD) has been shown to be feasible.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy of transcatheter interatrial septal shunt closure with prosthesis implantation in adults patients during long-term follow-up. In addition, the impact of thrombophilia and pulmonary hypertension on the outcome were investigated.
  
  
  METHODS
  Between June 1999 and November 2009, 287 patients (112 males, 43 ± 14 years) were treated in our institution by transcatheter closure of PFO (N = 175) or ASD (N = 112). Clinical and echocardiographic follow-up were prospectively performed at 1, 6 and 12 months followed by a 1 once a year evaluation.
  
  
  RESULTS
  All procedures were successful with eight procedural complications (2.7%): one stroke, two femoral pseudoaneurysms, three transient atrial fibrillation, two minors pericardial effusions. Among patients with presumed paradoxical embolism, thrombophilia was observed in 29 patients (17%); only one of them experienced a recurrent stroke. Among patients with ASD, pulmonary hypertension was observed in 32 cases (28%) and significantly reduced 6 months after shunt closure (from 47 ± 7 to 31 ± 11 mm Hg, P < 0.0001). 99% of patients achieved a complete follow-up. Clinical improvement was observed in 93%. Freedom from death, cardiac surgery or recurrent embolism was 98 ± 1% at 5 years.
  
  
  CONCLUSIONS
  Percutaneous transcatheter interatrial septal defect closure is a safe and effective treatment in adults patients, even in case of thrombophilia or pulmonary hypertension, during a long-term follow-up, up to 11 years.
authors.affiliation: Division of Cardiology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium. joelle.kefer@uclouvain.be
authors.forename: Joelle
authors.initials: J
authors.lastname: Kefer
authors.forename: Thierry
authors.initials: T
authors.lastname: Sluysmans
authors.forename: Cedric
authors.initials: C
authors.lastname: Hermans
authors.forename: Rames
authors.initials: R
authors.lastname: El Khoury
authors.forename: Catherine
authors.initials: C
authors.lastname: Lambert
authors.forename: Françoise
authors.initials: F
authors.lastname: Van de Wyngaert
authors.forename: Caroline
authors.initials: C
authors.lastname: Ovaert
authors.forename: Agnes
authors.initials: A
authors.lastname: Pasquet
mesh_terms: D000328:Adult; D021721:Balloon Occlusion / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome