Transcatheter closure of atrial septal defect in the elderly: a systematic review and meta-analysis
Authors' conclusion
Transcatheter ASD closure is beneficial for the elderly population since it improves functional capacity, biventricular dimensions, pulmonary pressures, TR severity and BNP. However, the incidence of atrial arrhythmias did not change significantly after the intervention.
Study context
- Population
- Patients ≥60 years old with secundum atrial septal defect
- Participants
- 1,184 patients18 single-arm cohorts
- Comparison
- After vs before transcatheter ASD closure
- Outcome
- RV end-diastolic diameter (right ventricular end-diastolic diameter (RVEDD)) and NYHA functional class change
Pooled result
As reported in the abstract
After closure vs Before closureSMD (95% CI)
RVEDD
−0.9(−1.2 to −0.7)
- NYHA functional class
- odds of being asymptomatic 9.5 (95% CI 5.06–17.79)
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| Systolic pulmonary arterial pressure (sPAP)After closurevs Before closure | MD −10.8 (95% CI −14.6 to −7) | |
| LV end-diastolic diameter (LVEDD)After closurevs Before closure | SMD 0.8 (95% CI 0.7–1.0) | |
| Brain natriuretic peptide (BNP)After closurevs Before closure | MD −68.3 (95% CI −114.4 to −22.1) | |
| −150−100−50050Difference (linear scale) |
| Outcome | OR (95% CI) | |
|---|---|---|
| Tricuspid regurgitation severityAfter closurevs Before closure | 0.39 (0.25–0.60) | |
| 0.20.5125Odds ratio (log scale) |
Atrial arrhythmias
- Neutral effect of ASD closure on atrial arrhythmias
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Transcatheter closure of atrial septal defect in the elderly: a systematic review and meta-analysis. Heart. Published 28 June 2023. doi:10.
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