Transcatheter Closure of Secundum Atrial Septal Defect in Patients Over 60 Years Old

Atrial septal defect (ASD) is the most frequently diagnosed congenital heart disease in adulthood. Along with the recent evolvement of therapeutic catheterization, transcatheter closure has become the treatment of choice in most secundum type ASDs in children and adults. However, clinical decision and technical details may be influenced by special circumstances including complex morphology of the defect, co-morbid disease, significant arrhythmia, pulmonary arterial hypertension (PAH), tricuspid or mitral insufficiency, ventricular dysfunction, and age of the patient, especially in very young or elderly patients. Pathophysiology in elderly patients with hemodynamically significant ASD shows the nature of the problems to be very complex; such problems are frequently combined and usually interacted negatively. Nevertheless, transcatheter ASD closure may be potentially subtracted from the treatment option because the risk-benefit relationship of the procedure has been less-clearly defined in this age group. In this issue, the article by Woo et al. reported the safety and efficacy of the transcatheter closure of ASD in elderly patients. In spite of the small cohort of patients, this study also demonstrated the substantial risk and complications frequently encountered in elderly patients with ASD. All of their patients who successfully underEditorial