Atrial Septal Stent Implant: Atrial Septal Defect Creation in the Management of Complex Congenital Heart Defects in Infants

Abstract

Patients presenting beyond the neonatal period with left heart obstructive defects and intact atrial septum or restrictive ASD present a challenging problem. We report a safe and effective technique for relief of left atrial hypertension in infants using premounted intravascular stents. All patients had immediate marked hemodynamic improvement.

The role of stents in the treatment of congenital heart disease: Current status and future perspectives

“…Therefore, atrial septal stent implantation has been successfully applied to promote a durable unrestrictive ASD. [3233141–145] The prior use of cutting balloons (Boston Scientific) may be helpful,[3233] as the microsurgical blades of the cutting balloon allow controlled tearing of the septal wall rather than stretching of the thickened ASD as seen with static balloon dilation. [33145] We and other authors in most cases use pre-mounted Palmaz-Genesis stents (Cordis; Johnson and Johnson, Miami, FL, USA) ranging from 7 to 8 mm in diameter and from 12 to 26 mm in length.…”

Off-pump atrial septostomy with thoracoscopic scissors under transesophageal echocardiography guidance

“…Static balloon dilation is unlikely to create a reliable atrial septal defect. Atrial septal stenting can potentially provide a reliable opening[1] but is technically very challenging and associated with risks. [2]…”

“…Catheter-based techniques tend to be relatively unreliable unless a stent is used. [1] Stenting of the atrial septum is risky and technically challenging, especially in very young patients. [2]…”

Interatrial shunt devices for heart failure with normal ejection fraction: a technology update

“…In an observational study of 5 patients with high LAP and lower right atrial pressure (RAP) as a result of congenital obstructive left heart defects, the creation of an interatrial communication alleviated left atrial hypertension and improved symptoms 33. Conversely, pulmonary edema can develop in some patients secondary to dramatic increases in LAP following closure of an atrial septal defect (ASD) 34,35…”