ArticleAnatolian journal of cardiology2026
Transcatheter Versus Surgical Closure of Atrial Septal Defect in Children and Adults: A Systematic Review and Meta-Analysis of Observational Studies.
Article in Anatolian journal of cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
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Abstract
backgroundAtrial septal defect closure can be performed surgically or via transcatheter intervention, yet comparative outcomes remain inconsistent between children and adults. This review synthesizes observational evidence to evaluate procedural success, complications, and periprocedural characteristics across both populations.
methodsA systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines was conducted, including 36 observational studies published through 2024. Study quality was assessed using the Newcastle-Ottawa Scale. Random effects models were applied, with subgroup analyses by age and procedure type. Publication bias was examined using funnel plots and Egger's test.
resultsThe pooled procedural success rate was 95% (95% CI: 92%-97%; I² = 90.2%). Among children, raw procedural success was 87% (1445/1656) for transcatheter closure and 99% (505/510) with surgery. In adults, transcatheter closure achieved 97% (95% CI: 90%-99%), whereas surgery reached 98% (95% CI: 70%-100%). Transcatheter closure resulted in shorter hospitalization (mean difference: -3.86 days, 95% CI: -6.03 to -1.69; P = .0004) and fewer major complications (risk ratio: 0.58, 95% CI: 0.39-0.86; P = .006). Sensitivity analysis restricted to high-quality studies (n = 12) remained consistent. Egger's regression did not indicate significant publication bias (P = .069).
conclusionBoth approaches provide high closure success, yet transcatheter intervention offers lower complication rates and faster recovery, particularly in anatomically suitable patients. These findings support individualized treatment selection based on age, anatomy, and institutional experience.
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