{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:38:01Z","timestamp":1790386681865,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000724","name":"Health Foundation","doi-asserted-by":"publisher","award":["685009"],"award-info":[{"award-number":["685009"]}],"id":[{"id":"10.13039\/501100000724","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To examine determinants of access to treatment, outcomes, and hospital utilization in patients undergoing secundum atrial septal defect (ASD) closure in adulthood in England and Wales.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Large retrospective cohort study of all adult patients undergoing secundum ASD closures in England and Wales between 2000\/01 and 2016\/17. Data were from population-based official data sets covering congenital heart disease procedures, hospital episodes, and death registries. Out of 6541 index closures, 79.4% were transcatheter [median age 47 years, interquartile range (IQR) 34\u201361] and 20.6% were surgical (40 years, 28\u201352). The study cohort was predominantly female (66%), with socioethnic profile similar to the general population. Mortality in hospital was 0.2% and at 1 year 1.0% [95% confidence interval (CI) 0.8\u20131.2%]. Risk of death was lower for transcatheter repairs, adjusting for age, sex, year of procedure, comorbidities, and cardiac risk factors [in-hospital adjusted odds ratio 0.09, 95% CI 0.02\u20130.46; 1-year adjusted hazard ratio 0.5, 95% CI 0.3\u20130.9]. There was excess mortality 1 year after ASD closure compared with matched population data. Median (IQR) peri-procedural length of stay was 1.8 (1.4\u20132.5) and 7.3 (6.2\u20139.2) days for transcatheter and surgical closures, respectively. Hospital resource use for cardiac reasons started the year before repair (median two inpatient and two outpatient-only days) and decreased post-repair (zero inpatient and one outpatient days during the first 2 years).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This national study confirms that ASD closure in adults, by surgical or transcatheter methods, is provided independently of ethnic or socioeconomic differences, it is low (but not no) risk, and appears to reduce future cardiac hospitalization even in older ages.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcae019","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:57:06Z","timestamp":1710377826000},"page":"78-88","source":"Crossref","is-referenced-by-count":3,"title":["Secundum atrial septal defect closure in adults in the UK"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7369-2322","authenticated-orcid":false,"given":"Kate M","family":"English","sequence":"first","affiliation":[{"name":"Department of Congenital Cardiology, Leeds General Infirmary , Great George Street, LS1 3EX, Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-7400","authenticated-orcid":false,"given":"Ferran","family":"Espuny-Pujol","sequence":"additional","affiliation":[{"name":"Clinical Operational Research Unit, University College London , 3rd Floor, 4 Taviton Street, WC1H 0BT, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1096-6242","authenticated-orcid":false,"given":"Rodney C","family":"Franklin","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Sydney Street, Chelsea , SW3 6NP, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1882-5476","authenticated-orcid":false,"given":"Sonya","family":"Crowe","sequence":"additional","affiliation":[{"name":"Clinical Operational Research Unit, University College London , 3rd Floor, 4 Taviton Street, WC1H 0BT, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2857-1628","authenticated-orcid":false,"given":"Christina","family":"Pagel","sequence":"additional","affiliation":[{"name":"Clinical Operational Research Unit, University College London , 3rd Floor, 4 Taviton Street, WC1H 0BT, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"2025011608362759500_bib1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s10334-018-0702-z","article-title":"Evaluation of atrial septal defects with 4D flow MRI\u2014multilevel and inter-reader reproducibility for quantification of shunt severity","volume":"32","author":"Chelu","year":"2019","journal-title":"MAGMA"},{"key":"2025011608362759500_bib2","first-page":"93","article-title":"Atrial septal defects\u2014clinical manifestations, echo assessment, and intervention","volume":"8","author":"Martin","year":"2015","journal-title":"Clin Med Insights Cardiol"},{"key":"2025011608362759500_bib3","first-page":"52","article-title":"Closure of atrial septal defects with the aid of hypothermia; 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