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Percutaneous Interventional Treatment of Atrial Septal Defect Secundum in Macedonia

Abstract Background: Atrial septal defect (ASD) is a common congenital heart disorder (CHD). While conventional open surgical treatment is the standard procedure in our country, percutaneous device closure with implantation of an atrial septal defect occluder is a promising alternative with very few peri and post procedural complications. Aim: The aim of the study was to present the rate of success and complications in percutaneous ASD closure with the implantation of an atrial septal defect occluder. Material and Methods: We treated 153 patients (ages 2-76; 65% female) with ASD secundum with percutaneous trans catheter closure using a septal occluder. Follow up was on a 3 month interval and assessment included clinical, electrophysiological and echocardiographic status. Results: The mean diameter of ASD obtained via balloon sizing was 16 ± 16 mm. Multiple ASDs were found in 20 (13%) patients and deficitary aortic and anterior rim (< 5 mm) was present in 16 (10%) patients. Due to inadequate placement and/or sizing, the device was removed and replaced in seven patients (5%). During follow up, trivial shunt was present in 4 (2.6%) patients. The diameter of the right ventricle corrected for age was reduced by an average of 20% by the first month and in 130 (86%) of patients it had normalized by one year of follow up. During follow up, 16 (10%) patients reported transient headaches and 3 (1.9%) patients had transient atrial fibrillation (AF). Conclusion: In conclusion, the implantation of a septal occluder was found to be a safe procedure that resulted in improved hemodynamic parameters that result from right ventricular volume overload with favorable short- and mid-term results.