Outcome Comparison between Transcatheter Closure and Surgical Closure of Atrial Septum Defect

Abstract

Introduction: Atrial septal defect (ASD) is a common congenital heart defect found in both children and adults, with potential serious complications if not addressed. Transcatheter device closure is a less invasive alternative to surgical correction, particularly for patients not suitable for the former.

Materials and Method: Patients and Methods: The study included 114 individuals treated at Ibn Al-Bitar Cardiac Surgery Center from June 2023 to July 2024. Patients with secundum ASD could choose between transcatheter or surgical closure, meeting specific defect criteria except for complex cases requiring surgery. Patients received information on risks, outcomes, and selected their preferred method. Surgical closures used cardiopulmonary bypass, while transcatheter procedures utilized the Amplatzer Septal Occluder.

Results: In comparison to surgical intervention, transcatheter closure demonstrated faster procedure times, no requirement for ICU admission, and shorter hospital stays. It achieved a higher success rate (97.8% vs. 91.3%) with fewer complications. Surgical procedures were more prone to complications such as wound infections and pneumonia, whereas device embolization was exclusive to the transcatheter cohort. Additionally, residual ASD occurrences were reduced in the transcatheter group

Conclusion: Transcatheter closure emerges as a safer, more efficient, and minimally invasive alternative to surgical repair for appropriate secundum ASD cases. However, surgical intervention remains vital for complex scenarios, highlighting the importance of meticulous patient selection and tailored interventions to enhance results. Additional research is warranted to evaluate the extended effects over time.

Keywords: atrial septal defect, surgery, device