Abstract
Background Atrial septal defect (ASD) and patent foramen ovale (PFO) are common interatrial communications with distinct pathophysiology and clinical implications. Percutaneous closure has emerged as the preferred treatment modality. This study evaluates long-term clinical outcomes following transcatheter closure of ASD and PFO. Methodology This retrospective cohort study analyzed 85 patients who underwent percutaneous closure of secundum ASD or PFO at King Abdulaziz Medical City, Jeddah, Saudi Arabia, between 2014 and 2024. Patients were evaluated using transesophageal echocardiography and transthoracic echocardiography. Procedural success, complications, and long-term outcomes were assessed. Results The cohort included 85 patients (mean age = 40.8 ± 15.2 years; 67.1% female). ASD was diagnosed in 58 (68.2%) patients, and PFO in 27 (31.8%) patients. Procedural success rate was 98.8% (84/85 patients). Major complications occurred in 2.4% of cases, including one device embolization requiring surgical retrieval and one case of cardiac tamponade. During a mean follow-up of 4.2 ± 2.8 years, complete symptom resolution was achieved in 82.4% of patients. New-onset atrial fibrillation developed in 3.5% of patients, and residual shunt was detected in 7.1% of cases. No recurrent embolic events were observed in the PFO group. Conclusions Percutaneous closure of ASD and PFO demonstrates high procedural success rates (98.8%) with low major complication rates (2.4%) and excellent long-term outcomes, including symptom resolution in 82.4% of patients. Device-based closure represents a safe and effective therapeutic strategy for appropriately selected patients with interatrial communications.