Long-term outcome after transcatheter closure of atrial septal defect in older patients: Impact of age at procedure

Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Shunji Sano, Hiroshi Itoh

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. Background The clinical benefits of transcatheter ASD closure in this aged population are controversial. Methods A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. Results During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. Conclusions Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age.

Original languageEnglish
Pages (from-to)600-606
Number of pages7
JournalJACC: Cardiovascular Interventions
Volume8
Issue number4
DOIs
Publication statusPublished - Apr 20 2015

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Atrial Heart Septal Defects
Heart Failure
Age Groups
Stroke
Hospitalization
Mortality
Kaplan-Meier Estimate
Disease-Free Survival
Survival Rate

Keywords

  • Atrial septal defect
  • older patients
  • outcome
  • transcatheter closure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Long-term outcome after transcatheter closure of atrial septal defect in older patients: Impact of age at procedure",
abstract = "Objectives This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. Background The clinical benefits of transcatheter ASD closure in this aged population are controversial. Methods A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. Results During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7{\%}). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90{\%} of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. Conclusions Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age.",
keywords = "Atrial septal defect, older patients, outcome, transcatheter closure",
author = "Yoichi Takaya and Teiji Akagi and Yasufumi Kijima and Koji Nakagawa and Shunji Sano and Hiroshi Itoh",
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T1 - Long-term outcome after transcatheter closure of atrial septal defect in older patients

T2 - Impact of age at procedure

AU - Takaya, Yoichi

AU - Akagi, Teiji

AU - Kijima, Yasufumi

AU - Nakagawa, Koji

AU - Sano, Shunji

AU - Itoh, Hiroshi

PY - 2015/4/20

Y1 - 2015/4/20

N2 - Objectives This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. Background The clinical benefits of transcatheter ASD closure in this aged population are controversial. Methods A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. Results During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. Conclusions Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age.

AB - Objectives This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. Background The clinical benefits of transcatheter ASD closure in this aged population are controversial. Methods A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. Results During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. Conclusions Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age.

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