AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 62 Submission ID: 1254 RESULTS OF TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT IN PATIENTS OLDER THAN 40 YEARS Ayoub Meddeb, Rym Gribaa, Marwen Kacem, Sami ben ouannes, Safa Dardouri, Imen Amamou, Sameh Ben Farhat, Aymen El Hraiech, Mehdi Slim, Elyes Neffati Tunisia Background: Transcatheter closure of atrial septal defects (ASD) is well known and demonstrated its safety and efficacy in children while it’s still controversial in adults older than 40 years. The closure of atrial septal defect prevents the development of pulmonary hypertension, cardiac arrhythmia and heart failure however the indications for atrial septal defect closure in adults are ambiguous. Aim: Evaluate the outcomes of transcatheter closure of secundum ASD in patients older than 40 years Material and method: We reviewed the results of 27 patients older than 40 years who underwent percutaneous closure of atrial septal defect at Cardiology department of Sahloul Hospital between 2000 and 2020 . Results: In this group, females represent 88,9%. The mean age was 51 years old with a minimum being 40 and a maximum being 69 years old. 66, 6% had exertional dyspnea at the presentation more than stage II NYHA classification. The ECG showed the presence of atrial fibrillation in 18,5%. About 29,6% had pulmonary hypertension before closure and the average of peak systolic pulmonary artery pressure was 43,6 mmHg. The echocardiographic assessment revealed a very enlarged right ventricle in 37%. The most used device was Amplatzer septal occluder in 88,6 % of all patients in this group. After ASD closure, 82.6 had no symptoms with a significant regression of mean peak systolic pulmonary pressure passing to 35, 3 mm Hg (P<0.001) and a net regression of the right ventricle size which was normal in 75% (P=0.04) in the follow up. We report the case of one patient who had developed an acute dyspnea the next day of the closure secondary to diastolic dysfunction with a good evolution. Conclusion: Transcatheter ASD closure in patients older than 40 years lead to a significant improvement of symptoms , a regression of the right ventricle size and pulmonary artery pressure. On this basis the Transcatheter ASD closure should be considered in adults at any age if it is technically feasible. MODERATED POSTER SESSION 4
RkJQdWJsaXNoZXIy NDIzNzc=