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Background: Transcatheter device closure (TCDC) and intraoperative device closure (IODC) have emerged as minimally invasive methods in the treatment of secundum atrial septal defects (ASDs), but the long-term safety and efficacy remains uncertain for the large ASDs.

Hypothesis: TCDC may be as safe and efficacious as IODC for closure of large ASDs in terms of long-term clinical outcomes.

Methods: Ninety-two patients who had ASDs with a defect diameter of ≥30 mm were included in this study.

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