The era of transcatheter closure of atrial septal defects

Open Access
Publisher Website
Google Scholar
Abstract
Because most defects are closed, we are unlikely ever to know the true natural history of patients with an atrial septal defect. The most detailed study available was that of Campbell in 1970,4which was based on a highly selected group of patients with large and clinically obvious defects in whom actuarial survival to the age of 60 was approximately 15%, whereas in the general population it is about 85%. Few would doubt that smaller defects carry a much better prognosis. Many aspects of the natural history are well known4 5 and in general terms closure of these defects does benefit most patients.6 Survival when surgical repair is done during the first few years of life is the same as that of a matched general population. Older age at operation is a risk factor for premature late death, a risk that begins after the first decade of life and becomes progressively more powerful as age at operation increases.