long-term follow up after transcatheter closure of atrial septal defect and patent foramen ovale in adults

Background: The aim of our study was to define long-term electrocardiographic and echocardiographic changes and complications after transcatheter closure of atrial septal defect and patent foramen ovale in adults.

Methods: The clinical, electrocardiographic and echocardiographic follow-up of 137 consecutive patients that underwent transcatheter closure of atrial septal defect (51 patients) or patent foramen ovale (86 patients) in a 10-year period was analyzed retrospectively.

Results: In the patent foramen ovale group, we observed no significant postprocedural changes. There were no changes in heart rate, heart rhythm and PR or QRS duration in both groups. In the atrial septal defect group, we observed a leftward shift in the heart axis (p = 0.017), a decrease in the estimated systolic pulmonary artery pressure (p = 0.024), decreased tricuspid early diastolic flow velocity (p = 0.002), a decrease in the right chamber dimensions (p = 0.0004) and interventricular septal movement normalization (p < 0.0001). Most of the complications were mild and occurred early after the procedure. Three early serious complications were documented.

Conclusions: No electrocardiographic or echocardiographic changes occurred after patent foramen ovale closure. Atrial septal defect closure is related to significant early morphological and hemodynamic improvement. Postprocedural complications are usually early and mild but serious late complications can occur. For that reason, long-term follow up is recommended in these patients.