BACKGROUND: Secundum @entity118 (ASDII) is a common @entity4297 , but the intervention, either transcatheter or surgical, needs are unclear. This study was to examine the paradigm shift in its intervention in an era of transcatheter closure. METHODS AND RESULTS: The study birth cohort 2000-2008 (2,070,145 live births) with complete postnatal medical data was derived from the national database (2000-2014) of Taiwan, a country with national health insurance and easily accessible high-standard medical care. We found 5,515 @entity1 with simple ASDII (median follow-up 12.2 years, one-third diagnosed after age 6 years, incidence 2.66/1,000 live births). Excluding @entity1 with coexisting @entity1757 , ASDII intervention was performed in 1,435 of 4,585 @entity1 : transcatheter closure in 1,080 (23.6%) and surgery in 355 (7.8%). The interventional need is 0.69 per 1,000 live births: 0.52 per 1,000 for transcatheter closure and 0.17 per 1,000 for surgery. In the era of transcatheter closure (July 2004-December 2014), ASDII intervention increased to 3.56-fold, but the number of operations decreased to half. The freedom from intervention was lower, and the age at intervention was younger (freedom from intervention at age 6 years, 0.749 vs 0.805, P < .001). In @entity1 born in the era of transcatheter closure, 19.5% (108/555) of the intervention was surgery. @entity713 occurred in 1.12% of those @entity1 after transcatheter closure and none after surgery (P = .149). CONCLUSIONS: In the era of catheter intervention, the interventional criteria for ASDII are less strict and one-third of the @entity1 may receive intervention, mostly transcatheter closure, at the pediatric ages.

Paradigm shift in the intervention for secundum XXXX in an era of transcatheter closure: A national birth cohort study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity713 :: ('MESH:D054537', 'Disease') :: ['Atrioventricular block'] @entity1757 :: ('MESH:D006345', 'Disease') :: ['ventricular septal defect'] @entity118 :: ('MESH:D006344', 'Disease') :: ['atrial septal defect'] @entity4297 :: ('MESH:D006330', 'Disease') :: ['congenital heart defect']
@entity118 :: (MESH:D006344,Disease) :: ['atrial septal defect']
