Am J Cardiovasc Dis 2012;2(2):133-142

Review Article
Percutaneous device closure of secundum atrial septal defect in older adults

Hossein Dehghani, Andrew J Boyle

Department of Medicine, Division of Cardiology, University of California San Francisco, San Francisco, CA, USA

Received March 16, 2012; accepted April 19, 2012; Epub May 15, 2012; Published June 15, 2012

Abstract: Ostium secundum atrial septal defect (ASD) is a common congenital heart defect. The adverse prognosis of
untreated ASD diagnosed in childhood is well studied and percutaneous device closure of these ASDs has evolved to
become the standard of care in both pediatric and young adult populations. There is a growing body of literature that
suggests the benefits of ASD closure are not restricted to younger populations. In older adults, there are beneficial effects
on cardiac chamber geometry, pulmonary artery pressures, patient symptoms and exercise capacity with closure of the
ASD, and these salutary effects appear to be more pronounced the earlier the defect is closed. There may even be a
reduction in the development of atrial arrhythmias, although this remains to be conclusively demonstrated. In this review,
we summarize the literature regarding ASD closure in older adults. The weight of evidence suggests that ASD should be
closed percutaneously earlier rather than later, and consideration should be given to percutaneous device closure of ASD
in adults upon diagnosis, rather than waiting for symptoms or cardiac chamber dilatation. (AJCD1203004).

Keywords: Ostium secundum atrial septal defect (ASD), congenital heart defect, percutaneous device closure, older adults


Address all correspondence to:
Dr. Andrew Boyle
University of California San Francisco
505 Parnassus Ave, Box 0124
San Francisco CA 94143, USA.
Tel: 415-514-0827
E-mail: aboyle@medicine.ucsf.edu
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