JOU-KOU WANGSHUENN-NAN CHIUMING-TAI LINCHUN-AN CHENCHUN-WEI LUMEI-HWAN WU2020-12-092020-12-0920170910-8327https://www.scopus.com/inward/record.uri?eid=2-s2.0-84982157006&doi=10.1007%2fs00380-016-0886-y&partnerID=40&md5=7db683a7f98e41b667f21b3b9b7f3dbehttps://scholars.lib.ntu.edu.tw/handle/123456789/525256We investigated the mid-to-long-term results of transcatheter closure of atrial septal defect (ASD) in patients ?40?years since there are issues with patients presenting with pulmonary hypertension and arrhythmia at the time of closure. In an 8.8 year period, transcatheter closure of ASD was successful in 179 patients aged ?40?years, but failed in 2. Of the 179 patients (44 males, median 53?years), NYHA functional class, presence of arrhythmia and severity of pulmonary hypertension were compared before and after closure. Patients with pulmonary hypertension (n?=?43, 24?%) were significantly older (60?±?11 vs. 52?±?9?years, p?<?0.01) and required larger devices (27?±?7 vs. 24?±?7?mm, p?=?0.04) than those without. Arrhythmia before intervention was documented in 31 patients (17.3?%): 22 atrial fibrillation (AF), 4 atrial flutter and 5 supraventricular tachycardia. Patients with AF or atrial flutter (n?=?26) were significantly older (63?±?10 vs. 53?±?10?years, p?=?0.048) and had a higher pulmonary artery mean pressure (29.2?±?12.6 vs. 20.2?±?7.6?mmHg, p?=?0.041) than those without. The mean follow-up period was 3.8?±?2.1?years. Early new-onset arrhythmia was documented in 23 patients of whom 1 had persistent AF, 1 developed sick sinus syndrome and others were in sinus rhythm at latest visit. There was significant improvement in NYHA functional class after closure (p?<?0.001). Of the 22 patients with AF, 10 were in sinus rhythm, 1 had paroxysmal AF, and 11 had persistent AF. Pulmonary hypertension persisted in 13 patients. Transcatheter closure of atrial septal defect in patients above 40?years is beneficial in terms of NYHA functional class, pulmonary artery pressure and cardiac rhythm. ? 2016, Springer Japan.[SDGs]SDG3adult; age; Article; clinical effectiveness; female; follow up; heart atrium flutter; heart atrium septum defect; human; interventional cardiovascular procedure; lung artery pressure; major clinical study; male; New York Heart Association class; paroxysmal atrial fibrillation; pulmonary hypertension; sick sinus syndrome; sinus rhythm; supraventricular tachycardia; transcatheter closure; treatment failure; aged; atrial fibrillation; Atrial Flutter; electrocardiography; heart catheterization; Heart Septal Defects, Atrial; Hypertension, Pulmonary; middle aged; Postoperative Complications; procedures; retrospective study; risk factor; septal occluder; severity of illness index; Taiwan; very elderly; Adult; Age Factors; Aged; Aged, 80 and over; Atrial Fibrillation; Atrial Flutter; Cardiac Catheterization; Electrocardiography; Female; Follow-Up Studies; Heart Septal Defects, Atrial; Humans; Hypertension, Pulmonary; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors; Septal Occluder Device; Severity of Illness Index; Taiwanjournal article10.1007/s00380-016-0886-y275310052-s2.0-84982157006