ASD Closure in Structural Heart Disease
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Purpose of Review
While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up.
With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published.
While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.
KeywordsAtrial septal defect (ASD) Iatrogenic ASD Septal defect closure Structural heart disease intervention Congenital heart disease
Compliance with Ethical Standards
Conflict of Interest
Dominik M. Wiktor has no financial disclosures relevant to the subject matter of this publication.
John D. Carroll served on the steering committee for the clinical trial RESPECT sponsored by St. Jude Medical and Abbott Vascular. Compensation for consulting services rendered in this role was paid to University Physician Inc. of the University of Colorado School of Medicine.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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