Transcatheter Closure Techniques for Atrial Septal Defects
Summary
Transcatheter closure of atrial septal defects has become the standard of care for ostium secundum lesions, offering a minimally invasive alternative to open surgery. The procedure is performed under combined fluoroscopic and echocardiographic guidance, most often via femoral venous access, to deploy an occluder device across the defect. Modern devices use self-expanding nitinol frames or fully biodegradable polymer constructs, often enhanced with bioactive surface coatings to accelerate endothelial coverage and reduce long-term foreign-body reactions. Three-dimensional imaging modalities refine device sizing and positioning, particularly in defects with deficient rims or adjacent venous structures. Adjustable locking mechanisms and novel delivery sheaths improve precision in challenging anatomies, including small infants and adults with complex septal morphology. Procedural success rates now exceed 95 per cent, with low incidences of device embolisation, erosions and residual shunts. Lifelong surveillance of rhythm disturbances, conduction abnormalities and late structural changes remains important to maintain optimal patient outcomes.
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Transcatheter Closure Techniques for Atrial Septal Defects publication trend
The graph below shows the total number of articles in transcatheter closure techniques for atrial septal defects across all publications each year (not limited to Nature Index journals).
Technical terms
Atrial septal defect (ASD): A congenital opening in the wall separating the left and right atria, causing left-to-right blood flow.
Transcatheter closure: A catheter-based intervention to deliver and deploy an implant that seals a cardiac septal defect without open surgery.
Occluder device: An implant, typically composed of a metallic framework or biodegradable polymer, designed to occupy and close a septal defect.
Endothelialisation: The process by which endothelial cells proliferate over an implant surface, promoting biocompatibility and reducing thrombogenicity.
Fluoroscopy: Live X-ray imaging used intra-procedurally to visualise catheters and device deployment in real time.
References
- Biodegradable Cardiac Occluder with Surface Modification by Gelatin–Peptide Conjugate to Promote Endogenous Tissue Regeneration. Advanced Science (2023).
- Outcome of transcatheter atrial septal defect closure in a nationwide cohort. Annals of Medicine (2023).
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