Surgical vs TranscatheterTuesday, July 14, 2026

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

1 min read·By E. Nolan Beckett, MD·Source: Turk gogus kalp damar cerrahisi dergisi

Key Numbers

3.2% of transcatheter cases

0.7% of Group I patients

2.6% of Group II patients

p<0.001

From The Valve Wire

This single-center retrospective compared 290 robot-assisted surgical ASD closures with 345 transcatheter closures over an unspecified span, with a 2019-onward subgroup (n=101 vs 105).

Robotic surgery had longer procedural times and hospital stays (P<0.001), but transcatheter closure carried a 3.2% device migration rate and more postoperative tricuspid regurgitation (P=0.003).

Neurological events trended higher with transcatheter closure (2.6% vs 0.7%, P=0.06).

In the contemporary subgroup, hospital stay, ventilation time, and ICU stay converged to statistical parity.

Source Abstract

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.

Authors: Can İ, Kadiroğulları E, Apaydın Z, Aksu T, Duman ZM et al.

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