Closure of ASD-II in Adults: Short-term and Long-term Follow-up

Dzhamil Asadov, David Iosseliani, Ilya Kovalchuk, Anna Rogatova, Vladislav Kriukov, Alexander Stepanov

Moscow City center for interventional cardioangiology, Moscow, Russia

Date, time and location: 2018.05.26 08:30, Exhibition area, 1st Floor. Zone – A

Abstract

Purpose: to study effectiveness and the safety of endovascular ASD closure in adults

Material and methods: 94 endovascular ASD-II closures were performed. The average age of patients was 47±15 years. The average ASD size was 18,3±6,6 mm (range, 10-35 mm). In 92,6% of cases (n=87) the ASD was located in the area of the fossa ovalis. In 2 cases (2,1%) there were two ASDs. All patients had signs of volume overload of the right heart

Results: In the majority of cases (75,5%) FigullaFlex (Occlutech) occluders were used. . The size of occluders varied from 12 to 40 mm (average, 25±7,2 mm). Technical success of endovascular ASD closure was achieved in 98,9% of cases. Complete ASD closure immediately after occluder implantation was achieved in 89 cases (94,7%). In the remaining 5 cases there was a residual shunt (≤ 3 mm). In one case, early after the procedure the occluder migrated into the pulmonary artery; surgical correction of the defect using a patch was performed (the defect diameter > 40 mm). Control examination (on the average, 13,5±1,5 months) revealed complete defect occlusion in 98,9% (an insignificant residual shunt persisted in 1 case). All occluders were stable, there were no late complications. During the follow-up, a significant decrease of the right heart volume was seen. The RA volume decreased from 48,6±5,6 to 32,6±3,8 cm3, the RV EDS – from 43±6,1 to 30,4±4,8 cm, the mean PAP – from 43±12,5 to 30,1±9,7 mm Hg (р<0,05). The general state improved in all patients. Conclusions: Endovascular ASD closure in adults is safe and effective method of treatment allowing to achieve significant improvement of clinical signs as well as of the dates of hemodynamics.