Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients

Abstract

Background: Adult patients with undiagnosed atrial septal defect (ASD) may have right heart cavity enlargement and functional tricuspid valve insufficiency. Moderate or more severe tricuspid regurgitation has been associated with a worse prognosis, and more serious complications are typically seen in older patients. This study aimed to evaluate the improvement in functional tricuspid regurgitation and heart geometry after transcatheter ASD closure in older patients.

Patients and methods: The data of 111 patients over 60 years of age with moderate or severe tricuspid regurgitation before ASD closure were analyzed.

Results: At the 1‑month and 6‑month follow-up after closure, both tricuspid regurgitation jet area and right atrial volume decreased significantly. Right ventricular volume decreased 1 month after closure, showing a further decrease at the end of the 6‑month follow-up. However, 24 patients (21.6%) still had persistent severe tricuspid regurgitation after the procedure. Multivariate analysis revealed that patient age at ASD closure and pulmonary artery systolic pressure determined by echocardiography before closure were predictors of persistent tricuspid regurgitation after closure.

Conclusion: Transcatheter ASD closure in older patients could significantly decrease tricuspid regurgitation and improve right heart geometry.

Keywords: Aged; Atrial septal defect; Cardiac catheterization; Heart enlargement; Tricuspid valve insufficiency.