A single centre retrospective study on balloon assisted technique in transcatheter closure of large atrial septal defects

Background: Data on balloon-assisted techniques (BAT) for transcatheter closure (TCC) of ostium secundum atrial septal defect (ASD-II) is scarce. The objective was to study the outcomes of the balloon-assisted technique (BAT) for transcatheter closure (TCC) of ostium secundum atrial septal defect. A single-centre retrospective study of patients with ostium secundum ASD who underwent balloon-assisted TCC. Results: This study included 36 patients. Thirty-three out of 36 patients with ASD-II and complex morphological features underwent successful BAT TCC. Our cohort of patients had a high prevalence of inadequate/floppy Aortic (90%), Posterior (40%) and Superior/Right upper pulmonary vein (25%) rims. Procedural success was defined as stable device position on post-procedure echocardiogram at 24-48 hours with no residual shunt. BAT was successful in 33 out of 36 patients (91.6%). The mean ASD size with BAT success was 27 mm. BAT was unsuccessful in 3 out of 36 patients. The combined deficiency and floppy nature of the Aortic, Superior, and Posterior rims was the reason for the failure of the Balloon-assisted technique along with the large size of ASD-II. BAT-failed patients were referred for emergent surgical device retrieval and closure of the atrial septal defect. No procedure-related mortality was encountered. Conclusions: Balloon-assisted device closure of ASD had a 90% success rate. BAT is a safe and effective technique in patients with large ASD-II. This technique enables controlled device delivery and alignment when conventional techniques fail.