Current practice in atrial septal defect occlusion in children and adults

Expert Rev Cardiovasc Ther. 2020 Jun;18(6):315-329. doi: 10.1080/14779072.2020.1767595. Epub 2020 May 22.

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; cardiac catheterization; congenital heart disease; echocardiography; pulmonary hypertension; transcatheter closure.

Publication types

  • Review

MeSH terms

  • Adult
  • Cardiac Catheterization*
  • Child
  • Echocardiography
  • Female
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome