Incidence and predictors of asymptomatic pericardial effusion after transcatheter closure of atrial septal defect.
OBJECTIVE
Pericardial effusion (PE) without obvious periprocedural complications (e.g., cardiac perforation, device erosion) may occur after transcatheter closure of secundum atrial septal defects (ASD). The aim of the study was to investigate the incidence and predictors of PE unrelated to procedural complications.


RESULTS
We included all patients who had undergone successful percutaneous ASD closure from June 2009 to April 2014 (n=2,652) with no pre-existing PE or cardiac perforation or erosion. Transthoracic echocardiography (TTE) was performed during the procedure and one, three, and six months postoperatively. After device implantation, fifty patients (1.9%) developed new-onset PE (37 immediately, 13 during follow-up). These patients were asymptomatic, stable haemodynamically, and had no new arrhythmias. PE appeared mild (5.1±1.9 mm) and homogeneously echolucent by TTE. PE diminished spontaneously. Compared with 2,602 patients without PE, factors independently predicting asymptomatic PE were the device touching the atrial free wall, device size, patient age, and total defect size. Areas under the receiver operating characteristic curves were 0.78 (p<0.001), 0.66 (p<0.001) and 0.77 (p<0.001) for device size, patient age, and total defect size, respectively.


CONCLUSIONS
This is the first systematic report of a new type of PE. Our data provide new insights into new-onset PE after percutaneous ASD closure.
Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Jingjin
J
Wang
Mehul
M
Patel
Minghu
M
Xiao
Zhongying
Z
Xu
Shiliang
S
Jiang
Xin
X
Sun
Liang
L
Xu
Hao
H
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000601:surgery; D006328:Cardiac Catheterization / Q000009:adverse effects; D002648:Child; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000453:epidemiology*; D055989:Septal Occluder Device / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult