Current practice in atrial septal defect occlusion in children and adults

ABSTRACT

Introduction

Atrial septal defect (ASD) is one of the most common congenital heart diseases (CHD) in children and adults. This group of malformations includes several types of atrial communications allowing shunting of blood between the systemic and the pulmonary circulations. Early diagnosis and treatment carries favorable outcomes. Patients diagnosed during adulthood often present with complications related to longstanding volume overload such as pulmonary artery hypertension (PAH), atrial dysrhythmias, and right (RV) and left (LV) ventricular dysfunction.

Area covered

This article intended to review all aspects of ASD; anatomy, pathophysiology, clinical presentation, natural history, and indication for treatment. Also, we covered the transcatheter therapy in detail, including the procedural aspect, available devices, and outcomes.

Expert opinion

There has been a remarkable improvement in the treatment strategy of ASD over the last few decades. Transcatheter closure of ASD is currently accepted as the treatment of choice in most patients with appropriately selected secundum ASDs. This review will focus on the most recent advances in diagnosis and treatment strategy of secundum ASD.

KEYWORDS:

• Atrial septal defect
• transcatheter closure
• echocardiography
• congenital heart disease
• pulmonary hypertension
• cardiac catheterization

Article highlights

• ASD is not uncommon disease, and it carries significant mortality and morbidity if not treated early.

• The advancements in imaging modalities led to early diagnosis and better assessment of such condition.

• Patient selection for device closure is crucial to avoid unnecessary procedural and long-term complications.

• Transcatheter therapy proved itself as safe with excellent procedural and long-term outcomes.

The advancements in the technology of manufacturing the ASD closure devices are challenging and it aim to add more safety features and better outcomes.

Declaration of interest

ZM Hijazi is consultant for Occlutech ASD closure device. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.