Effect of percutaneous atrial septal defect and patent foramen ovale device closure on degree of aortic regurgitation

Background In recent years, percutaneous device closure has become commonplace for treatment of atrial septal defect (ASD) and patent foramen ovale (PFO). However, the effect of device closure on aortic valve regurgitation (AR) has been questioned. Objective The purpose of this study was to define changes in AR using echocardiography, before and after device closure of ASD or PFO. Methods We retrospectively reviewed all patients who had percutaneous device closure of ASD or PFO at our institution between 2005 and 2009. We compared the preprocedure echocardiogram to the most recent follow-up study. All investigators were blinded to referral diagnosis, patient demographics, and size and type of the device placed. Aortic regurgitation was graded as none/trivial, mild, moderate, or severe. Results Overall, 322 patients qualified for inclusion; 204 with PFO and 118 with ASD. Mean age at time of closure was 48 ± 20 years (range 3-85 years). Mean duration of follow-up was 1.2 years (range 2 months to 5 years). Only two patients (0.6%) demonstrated any appreciable increase in AR severity. However, both of these patients manifested a clinically insignificant change from a trivial to mild grade of aortic regurgitation. Conclusions Percutaneous device closure of PFO or ASD does not increase the incidence or severity of AR over medium-term follow-up.