title: Beneficial effects of transcatheter closure of atrial septal defects not only in young adults.
abstract: OBJECTIVE
  To compare cardiac events and remodeling effects after transcatheter closure of atrial septal defects (ASD) in pediatric, adult, and older adult patients.
  
  
  METHODS
  A retrospective review was conducted of 353 patients who underwent transcatheter ASD closure between February 1999 and December 2007 at Siriraj Hospital. The patients were divided into 3 groups according to age: children (<18 years; n = 99); adults (18-50 years; n = 169); and older adults (>50 years; n = 85). Cardiac events at 1 year, and changes in left and right ventricular dimensions between preprocedure and 6 months and 1 year postprocedure were compared between groups.
  
  
  RESULTS
  Of the 353 patients, the average size of ASD was 22.1 ± 6.6 mm. Device: ASD diameter was 1.25 ± 0.28 mm. At 1 year postprocedure, the prevalence of chest discomfort and atrial fibrillation (AF) was higher in older adult patients, compared to the other age groups. Device embolization, cardiac erosion, pericardial effusion, syncope, migraine, thrombus formation, and residual shunt did not differ between groups. Within the first 6 months, the right ventricular (RV) dimension tended to dramatically decrease, while the left ventricular (LV) dimension increased in all age groups. These changes leveled off in children and in older adults, but in the adult group (18-50 years), RV shrinkage and LV expansion continued for 1 year. A low rate of early and late complications was noted.
  
  
  CONCLUSIONS
  Transcather closure of ASD can cause cardiac remodeling, regardless of the patient's age at the time of the procedure. For older adult patients, the long-term risk of AF continuation and chest discomfort is likely.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand. chodchan@ualberta.ca
authors.forename: Chodchanok
authors.initials: C
authors.lastname: Vijarnsorn
authors.forename: Kritvikrom
authors.initials: K
authors.lastname: Durongpisitkul
authors.forename: Prakul
authors.initials: P
authors.lastname: Chanthong
authors.forename: Paweena
authors.initials: P
authors.lastname: Chungsomprasong
authors.forename: Jarupim
authors.initials: J
authors.lastname: Soongswang
authors.forename: Duangmanee
authors.initials: D
authors.lastname: Loahaprasitiporn
authors.forename: Apichart
authors.initials: A
authors.lastname: Nana
authors.forename: Suruthai
authors.initials: S
authors.lastname: Kurasirikul
authors.forename: Kachaporn
authors.initials: K
authors.lastname: Nimdet
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D055989:Septal Occluder Device / Q000009:adverse effects*; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology; D055815:Young Adult