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Percutaneous closure of atrial septal defects by the Brazilian Health System: an economically feasible option

Atrial septal defect (ASD) is one of the most frequent congenital malformations, representing 5% to 10% of all congenital heart defects. The most common type is the ostium secundum ASD (OS ASD), and represents 75% of these malformations. When diagnosed late or left untreated, in addition to abnormalities in the clinical examination, there may be heart failure, cardiac arrhythmias, mitral insufficiency, right ventricular overload and pulmonary hypertension. In advanced cases with severe pulmonary hypertension and interatrial shunt reversal (right to left), there is cyanosis, which indicates severe cardiopulmonary disease and increased mortality. In the last decades, with the improvement of percutaneous techniques and devices, the possibility of percutaneous treatment of congenital defects has increased dramatically. Several studies have shown excellent early and long-term results of percutaneous atrial septoplasty. In addition to providing greater comfort for patients, lower complication rates, less in-hospital and extra-hospital recovery time and efficacy similar to that of surgical atrial septoplasty in developed countries, it is definitely the most economic option. There is no doubt that in the near future, the cost-effectiveness ratio of this procedure will also be observed in developing countries such as Brazil, where the cost of the prosthesis is, to this day, the major obstacle for the standardization of this procedure and the amounts paid for surgical procedures are outdated.

Heart septal defects, atrial; Heart defects, congenital; Prostheses and implants


Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI R. Beira Rio, 45, 7o andar - Cj 71, 04548-050 São Paulo – SP, Tel. (55 11) 3849-5034, Fax (55 11) 4081-8727 - São Paulo - SP - Brazil
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