Comparison of robot-assisted surgical and transcatheter closure of secundum atrial septal defect: A single-center retrospective study.

BACKGROUND

Atrial septal defect (ASD) closure can be performed using either transcatheter or robot-assisted surgical approaches. This study aimed to compare the clinical outcomes, procedural characteristics, and complications associated with these two techniques in a large patient cohort.

METHODS

A retrospective analysis was conducted on 635 patients who underwent ASD closure via either robot-assisted surgery (Group I, n=290) or transcatheter closure (Group II, n=345). Preoperative, perioperative, and postoperative data, including procedural times, complications, and follow-up outcomes, were evaluated. In addition, patients treated after 2019 were analyzed as a subgroup and categorized as Group Is (robot-assisted surgery, n=101) and Group IIs (transcatheter closure, n=105).

RESULTS

Patients in Group I had significantly longer procedural times and hospital stays than those in Group II (p<0.001). Postoperative tricuspid regurgitation was more frequent in the transcatheter group (p=0.003). Device migration occurred in 3.2% of transcatheter cases. Overall neurological events occurred in 0.7% of Group I patients and 2.6% of Group II patients (p=0.06). No significant difference in postoperative arrhythmia rates was observed between the groups. In the subgroup analysis of patients treated after 2019, the mean hospital stay was 2.36±0.5 days in Group Is and 2.21±0.6 days in Group IIs (p=0.07). Ventilation time was 3.6±1.4 hours versus 3.1±1.9 hours (p=0.05), and intensive care unit stay was 7.8±2.9 hours versus 7.2±3.0 hours (p=0.20), respectively.

CONCLUSION

Both transcatheter and robot-assisted surgical ASD closure are safe and effective when patients are appropriately selected. Robot-assisted surgery offers the additional advantage of concomitant tricuspid valve annuloplasty and demonstrates improved outcomes with increasing surgical experience. Larger prospective multicenter studies are needed to further validate these findings.