SynthesisHeart (British Cardiac Society)2023
Transcatheter closure of atrial septal defect in the elderly: a systematic review and meta-analysis.
Synthesis in Heart (British Cardiac Society), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Improvement of Hemodynamics and Quality of Life Before and After Interatrial Shunt Devices Implantation for Chronic Heart Failure: A Systematic Review and Meta-analysis.Current cardiology reviews · 2025Pooled it
- Transcatheter closure of atrial septal defect in the elderly: a systematic review and meta-analysis.Heart (British Cardiac Society) · 2023Pooled it
- Long-Term Outcomes of Atrial Septal Defect Closure in Adults Older than 50 Years.Pediatric cardiology · 2026Article
- Percutaneous Closure of a Giant Secundum Atrial Septal Defect Using 2 Sutured Occluders.JACC. Case reports · 2026Article
- Staged Therapeutic Approach to Concomitant Severe Aortic Stenosis and Atrial Septal Defect: Addressing Dual Mechanisms of Heart Failure-Case Report and Literature Review.Life (Basel, Switzerland) · 2026Article
- Neovascularization and Neo-Endothelialization After Atrial Septal Defect Closure.JACC. Case reports · 2026Article
- Echocardiographic Evaluation of Right Heart and Hemodynamic Changes After Transcatheter Secundum Atrial Septal Defect Closure in Adults: A Single-Center Retrospective Study.Cardiology research · 2025Article
- Interventions for adult congenital heart disease.Nature reviews. Cardiology · 2025Review
- Comparing the impact of transcatheter ASD closure on echocardiographic indices in adults below and above 50 years.Echo research and practice · 2025Article
- Atrial Septal Defect Presenting as Fleischner's Sign in an Elderly Patient: A Case Report.Cureus · 2025Article
- Secundum atrial septal defect closure in adults in the UK.European heart journal. Quality of care & clinical outcomes · 2025Observational
- Surgical Treatment of Atrial Septal Defects.Reviews in cardiovascular medicine · 2024Review
- Successful Evolution of Atrial Septal Defect Closure in an Elderly Patient With Complex Cardiovascular Disease.CASE (Philadelphia, Pa.) · 2024Article
- Review
- Atrial Fibrillation Ablation in Congenital Heart Disease: Therapeutic Challenges and Future Perspectives.Journal of the American Heart Association · 2024Review
- Sequential percutaneous intervention for sinus venosus defect and significant coronary artery disease.Annals of pediatric cardiologyArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDespite the establishment of transcatheter closure as the treatment of choice in adults with secundum atrial septal defects (ASDs), the effectiveness of this approach in the elderly is disputed. This systematic review and meta-analysis aims to explore the impact of transcatheter ASD closure in patients ≥60 years old.
methodsWe systematically searched four major electronic databases (PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus and Web of Science), ClinicalTrials.gov, article references and grey literature. Primary outcomes were the right ventricular end-diastolic diameter (RVEDD) and the New York Heart Association functional class change, whereas secondary outcomes included systolic pulmonary arterial pressure (sPAP), left ventricular end-diastolic diameter (LVEDD), brain natriuretic peptide (BNP), tricuspid valve regurgitation (TR) change, as well as the rate of atrial arrhythmias and all-cause mortality.
resultsIn total, 18 single-arm cohorts comprising 1184 patients were included. RVEDD was reduced after ASD closure (standardised mean difference (SMD) -0.9, 95% CI -1.2 to -0.7). Elderly patients had 9.5 times higher odds of being asymptomatic after ASD closure (95% CI 5.06 to 17.79). Furthermore, ASD closure improved sPAP (mean difference (MD) -10.8, 95% CI -14.6 to -7), LVEDD (SMD 0.8, 95% CI 0.7 to 1.0), TR severity (OR 0.39, 95% CI 0.25 to 0.60) and BNP (MD -68.3, 95% CI -114.4 to -22.1). There was a neutral effect of ASD closure on atrial arrhythmias.
conclusionsTranscatheter 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. PROSPERO REGISTRATION NUMBER: CRD42022378574.
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