Effect of percutaneous atrial septal defect and patent foramen ovale device closure on degree of aortic regurgitation

Loar, Robert W.; Johnson, Jonathan N.; Cabalka, Allison K.; Cetta, Frank; Hagler, Donald J.; Eidem, Benjamin W.; Taggart, Nathaniel W.

doi:10.1002/ccd.24779

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…5,6,35 Whether device closure of ASD carries a risk of progressive aortic insufficiency remains controversial. 12,45 In our case series of large ASDs, neither device erosion nor delayed aortic regurgitation occurred, and no other long-term complications developed. Supraventricular arrhythmias resolved in 47.4% of patients and persistent or newly developed atrial fibrillation was well controlled medically, in keeping with previous reports.…”

Section: Long-term Outcomes After Large Asd Closurementioning

confidence: 63%

Transcatheter Closure of Large Atrial Septal Defects

Baruteau

Petit

Lambert

et al. 2014

Circ: Cardiovascular Interventions

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Background-Data are needed on the safety and efficacy of device closure of large atrial septal defects. Methods and Results-Between 1998 and 2013, 336 patients (161 children <15 years) with large, isolated, secundum atrial septal defects (balloon-stretched diameter ≥34 mm in adults or echocardiographic diameter >15 mm/m 2 in children) were managed using the Amplatzer device, at the Marie Lannelongue Hospital. Transthoracic echocardiographic guidance was used starting in 2005 (n=219; 65.2%). Balloon-stretched diameter was >40 mm in 36 adults; mean values were 37.6±3.3 mm in other adults and 26.3±6.3 mm/m 2 in children. Amplatzer closure was successful in 311 (92.6%; 95% confidence interval, 89%-95%) patients. Superior and posterior rim deficiencies were more common in failed than in successful procedures (superior, 24.0% versus 4.8%; P=0.002; and posterior, 32.0% versus 4.2%; P<0.001). Device migration occurred in 4 adults (2 cases each of surgical and transcatheter retrieval); in the 21 remaining failures, the device was unreleased and withdrawn. After a median follow-up of 10.0 years (2.5-17 years), all patients were alive with no history of late complications. Conclusions-Closure of large atrial septal defects using the Amplatzer device is safe and effective in both adults and children. Superior and posterior rim deficiencies are associated with procedural failure. Closure can be performed under transthoracic echocardiographic guidance in experienced centers. Early device migration is rare and can be safely managed by device extraction. Long-term follow-up showed no deaths or major late complications in our population of 311 patients. (Circ Cardiovasc Interv. 2014;7:837-843.)

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Section: Long-term Outcomes After Large Asd Closurementioning

confidence: 63%

Transcatheter Closure of Large Atrial Septal Defects

Baruteau

Petit

Lambert

et al. 2014

Circ: Cardiovascular Interventions

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“…The Doppler technique is highly sensitive to small leakages, so these regurgitations may be only a few milliliters [19] . In a recent follow-up study after percutaneous closure, the presence of trace AR was not regarded as AR [20] . With this approach, the current study thus shows AR in only one patient (2%) and no new AR after closure.…”

Section: Discussionmentioning

confidence: 99%

Absence of significant aortic regurgitation seven years after closure of patent foramen ovale

Mirzada

Ladenvall

Johansson

2014

IJC Heart & Vessels

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BackgroundIt has been suggested that there is an increase in aortic regurgitation (AR) in the short and medium term after percutaneous closure of patent foramen ovale (PFO). The aim of this study is to determine the long-term effect of percutaneous closure of PFO on the prevalence of AR.MethodsPatients with cryptogenic stroke or transient ischemic attack who had undergone percutaneous closure of PFO more than five years before the study were invited to an echocardiographic examination.ResultsOut of 83 invited patients, 64 accepted the invitation and were examined with echocardiography. Mild AR was found in one patient (2%), but this was already evident in the patient's echocardiographic result before PFO closure. Trace AR was detected in 11 patients (17%). No case of moderate or severe AR was detected. Patients with AR were more often hypertensive (six out of 12 patients with AR, compared to nine of the 52 without AR, p = 0.025), and the indexed sinus of Valsalva was larger in patients with AR (18.6 mm/m2, SD 1.6, as compared to 17.3 mm/m2, SD 1.6, p = 0.02).ConclusionIn this long-term study with a minimum follow-up of 5.6 years and a mean of 7.1 years, we found negligible levels of AR. Where present, AR was associated with hypertension and mild dilatation of the aortic root, but there was no indication that device closure per se increased the risk of developing AR.

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