ผลลัพธ์การรักษาผู้ป่วยโรคผนังกั้นหัวใจห้องบนรั่วด้วยการใส่อุปกรณ์ปิดทางสายสวน ณ ศูนย์หัวใจสิริกิติ์ ภาคตะวันออกเฉียงเหนือ มหาวิทยาลัยขอนแก่น

Chitrada  Ungprasert; Phuangpaka  Ungprasert; Khunniti  Phonla

doi:10.64960/srimedj.v41i4.271151

Authors

Chitrada Ungprasert Division of Cardiology, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 400002
Phuangpaka Ungprasert Division of Cardiology, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 400002
Khunniti Phonla Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 40002

DOI:

https://doi.org/10.64960/srimedj.v41i4.271151

Keywords:

secundum atrial septal defect, transesophageal echocardiography, transcatheter device closure

Abstract

Background and objectives: Transcatheter device closure is currently the first-line treatment for secundum atrial septal defect (ASD). After transesophageal echocardiography (TEE) confirms suitable anatomy for device closure, normally patients are often scheduled for transcatheter treatment because of shorter recovery time, reduced length of hospital stays, and fewer complications compared with surgery. This study aimed to evaluate the outcomes of transcatheter closure of secundum ASD in adults at Queen Sirikit Heart Center, Khon Kaen University.

Methods: This retrospective descriptive study included adult patients aged over 18 years with secundum ASD treated at Queen Sirikit Heart Center, between April 1, 2018, and March 31, 2024. TEE was performed to assess defect size and surrounding rims. Patients with anatomy suitable for device closure underwent transcatheter ASD closure. The primary outcome was procedural success rate, and the secondary outcome was the incidence of complications.

Results: A total of 132 patients were included, with a mean age of 50.9 ± 15.5 years; 105 patients were female (79.5%). The most common presenting symptom was dyspnea. The mean ASD size measured by TEE was 2.12 ± 0.59 cm. Mild pulmonary hypertension was observed, with a mean pulmonary artery pressure of 30 mmHg. Successful transcatheter closure was achieved in 130 patients (98%). The mean length of hospital stay was 2 days. No major complications were observed. Minor complications included arrhythmia in 10 patients (7.7%) and mild residual shunt in 7 patients (5.4%) after device closure.

Conclusion: Transcatheter device closure for secundum atrial septal defect is a safe and effective treatment in adult patients. This study suggested detailed anatomical assessment using transesophageal echocardiography is essential for optimal outcomes. Our findings also show that the procedure offers short recovery time, minimal invasiveness, short hospital stay, and a low complication rate. Minor complications included arrhythmia and mild residual shunt.

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