STRUCTURED ABSTRACT
Introduction: Elderly patients with ASD often present with
chronic atrial fibrillation and large left to right shunt. This study
reports the experience of left atrial appendage (LAA) and atrial septal
defect (ASD) closure in patients with significant ASD and chronic atrial
fibrillation.
Methods / Results: We report six consecutive elderly patients
with chronic atrial fibrillation and significant ASD who underwent LAA
and fenestrated ASD closure from 1 January 2014 until 31 December 2019.
All periprocedural and long term (>1 year) outcomes were
reported. Six patients (Male: 33.3%; Mean age: 66.8±3.3 years) were
included. Mean CHADS2,
CHA2DS2-VASc and
HAS-BLED scores were 2.33±0.82, 3.83±0.75 and 1.83±0.75. Four patients
underwent simultaneous procedure while 2 patients underwent a staged
procedure. Procedural success was achieved in all patients. Total
occlusion was achieved during LAA occlusion without device embolization
prior to ASD closure. Patients who underwent simultaneous procedure had
a shorter total hospital stay and lower total hospital stay. During a
follow-up period of 32.8±19.4 months, both the devices were well seated.
No device-related thrombosis or erosion reported. All patients remained
in atrial fibrillation. No patients experienced any thromboembolic
stroke or transient ischemic attack.
Conclusion: LAA and ASD closure is feasible and can be safely
performed in the same seating in elderly patients with a significant
atrial septal defect.