PT - JOURNAL ARTICLE AU - Margarita Brida AU - Gerhard-Paul Diller AU - Aleksander Kempny AU - Maria Drakopoulou AU - Darryl Shore AU - Michael A Gatzoulis AU - Anselm Uebing TI - Atrial septal defect closure in adulthood is associated with normal survival in the mid to longer term AID - 10.1136/heartjnl-2018-314380 DP - 2019 Jul 01 TA - Heart PG - 1014--1019 VI - 105 IP - 13 4099 - http://heart.bmj.com/content/105/13/1014.short 4100 - http://heart.bmj.com/content/105/13/1014.full SO - Heart2019 Jul 01; 105 AB - Objective The prognostic benefit of atrial septal defect (ASD) closure in adulthood, particularly in advanced age, remains uncertain. The aim of our study was to examine the impact of ASD closure in a contemporary adult cohort on mid to longer term survival as compared with expected survival in the general population.Methods We study herewith all consecutive patients (≥16 years of age) who underwent ASD closure, catheter or surgical, at our tertiary centre between 2001 and 2012. Furthermore, we compare survival of our ASD closure cohort with expected survival in age and gender-matched general population and standardised mortality ratios (SMR) were calculated.Results A total of 608 patients (mean age 45.4±16.7 years) underwent ASD closure (catheter 433(71.2%), surgical 175(28.8%)). There was no 30-day mortality and periprocedural complications were low (n=40, 6.6%). During a median follow-up of 6.7 (IQR 4.2–9.3) years 16 (2.6%) patients died; survival was similar to the general population (p=0.80) including patients >40 or >60 years of age at ASD closure (p=0.58 and p=0.64, respectively). There was no survival difference between gender (male: SMR 0.93; 95% CI 0.52 to 1.64, p=0.76; female: SMR 0.99; 95% CI 0.58 to 1.66, p=0.95) or mode of closure compared with general population (catheter: SMR 1.03; 95% CI 0.68 to 1.55, p=0.89; surgical: SMR 0.65; 95% CI 0.22 to 1.88, p=0.38).Conclusion Perioperative mortality and morbidity in a large contemporary adult cohort undergoing ASD closure, catheter or surgical, is extremely low. Mid to longer term survival is excellent irrespective of age, gender and mode of closure, and similar to matched general population.