Percutaneous closure of secundum atrial septal defects in pediatric and adult patients: short- and mid-term follow-up results

Kaya, Yüksel; Yurtdaş, Mustafa; Ceylan, Yemlihan; Bulut, Mustafa; Söylemez, Nihat; Güvenç, Tolga Sinan; Karakurt, Ahmet; Akdemir, Ramazan; Öztürk, Hasan; Güneş, Yılmaz; Balcı, Bahattin; Özkan, Mehmet

doi:10.5543/tkda.2013.84031

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Mean procedure duration for fluoroscopy-guided percutaneous ASD closure has been reported to range from 40 to 110 minutes, although it should be noted that the definition of total the procedure time varied among studies. [ 9 , 14 , 15 , 17 ] In the present study, procedure time (measured from heparinization to removal of the delivery system) was significantly shorter in the TEE group (21.5 ± 14.6 minutes) than in the fluoroscopy group (28.6 ± 10.9 minutes). Ewert et al [ 41 ] also reported numerically shorter duration for TEE-guided ASD closure (88 minutes) than for conventional fluoroscopy-guided ASD closure (100 minutes), but the difference was not statistically significant ( P = .09).…”

Section: Discussionmentioning

confidence: 45%

“…Numerous studies have reported the use of fluoroscopy-guided procedures for the percutaneous closure of ASD and most of these studies used fluoroscopy in combination with TEE or TTE. [ 9 , 11 , 12 , 14 , 17 , 21 , 22 ] Previous studies in pediatric patients using procedures guided by both fluoroscopy and TEE or TTE have reported successful implantation rates of 93% to 100%, low complication rates of 0% to 20% (predominantly minor complications), and good long-term outcomes. [ 8 , 10 , 14 , 15 , 17 ] In the present study, the fluoroscopy group showed a successful implantation rate of 100% and the complication rate was 13%, which are in agreement with the previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, radiation exposure during fluoroscopy represents a risk to the patient and medical staff. [ 18 – 20 ] Because percutaneous ASD closure under fluoroscopic guidance is usually carried out with the assistance of transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE), [ 9 , 11 , 12 , 14 , 17 , 21 – 34 ] it has been suggested that echocardiography alone could be used to guide device placement. TEE or TTE without fluoroscopy have been used successfully to guide peratrial or perventricular repair of ventricular septal defects.…”

Section: Introductionmentioning

confidence: 99%

“…TEE or TTE without fluoroscopy have been used successfully to guide peratrial or perventricular repair of ventricular septal defects. [ 4 , 7 – 9 , 21 , 22 , 26 , 30 , 31 , 35 – 40 ] Some studies have reported the use of TEE or TTE to guide percutaneous ASD closure without fluoroscopy. [ 37 – 42 ] Nevertheless, data about the direct comparison of the efficacy and safety between TEE-guided and fluoroscopy-guided procedures are limited.…”

Section: Introductionmentioning

confidence: 99%

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Transesophageal echocardiography and fluoroscopy for percutaneous closure of atrial septal defects

Li²,

Ye³

et al. 2018

Medicine

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The aim of the study was to compare transesophageal echocardiography (TEE) and fluoroscopy for percutaneous atrial septal defect (ASD) closure.This was a retrospective analysis of children who underwent percutaneous ASD closure. The procedure was guided by TEE without fluoroscopy in 130 patients (TEE group) and by fluoroscopy in 163 patients (fluoroscopy group). Baseline demographic/clinical characteristics were recorded. Patients were followed until hospital discharge. Outcomes were procedure duration, peri/postoperative complications, hospital stay, and costs.The TEE and fluoroscopy groups showed no significant differences in age (71.7 ± 40.7 vs 62.5 ± 38.8 months), male/female ratio (54/76 vs 66/97), weight (22.0 ± 12.0 vs 20.1 ± 9.0 kg), ASD diameter (9.9 ± 4.2 vs 9.3 ± 3.9 cm), distances to the superior vena cava (13.4 ± 4.6 vs 13.3 ± 4.2 cm), inferior vena cava (13.4 ± 4.3 vs 13.9 ± 4.1 cm) and atrial septal roof (12.1 ± 4.0 vs 12.3 ± 3.2 cm), or atrial septal size (38.2 ± 6.2 vs 39.4 ± 26.6 cm); distance to the mitral valve was greater in the TEE group (13.2 ± 4.4 vs 11.3 ± 3.9 cm; P < .001). The TEE and fluoroscopy groups showed no significant differences in occlusion device size (14.3 ± 4.6 vs 13.8 ± 4.0 cm) or sheath size (8.7 ± 1.8 vs 8.7 ± 0.9 cm), but procedure duration was shorter in the TEE group (21.5 ± 14.6 vs 28.6 ± 10.9 minutes; P < .001). Postoperative fever (>38°C) occurred less frequently in the TEE group than in the fluoroscopy group (0.8% vs 9.2%; P < .001); there were no significant differences for the other complications. No patient had postoperative residual shunt, occlusion device shedding/displacement, or pericardial effusion. The TEE group had longer hospital stay (3.2 ± 0.6 vs 2.9 ± 0.6 days; P < .001) and higher procedure cost (29,687 ± 4218 vs 28,530 ± 1668 CNY (China Yuan); P = .002) than the fluoroscopy group.TEE-guided percutaneous ASD closure can be used as an alternative to fluoroscopy-guided procedures and avoids the use of radiation or contrast agents.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transesophageal echocardiography and fluoroscopy for percutaneous closure of atrial septal defects

Li²,

Ye³

et al. 2018

Medicine

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Transcatheter Closure of Patent Ductus Arteriosus in Children with the Occlutech Duct Occluder

et al. 2017

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The aim of this study was to evaluate the feasibility, efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with the Occlutech duct occluder (ODO) in children. We reviewed the clinical records of 71 patients who underwent percutaneous closure of PDA with an ODO between September 2014 and August 2016. The Occlutech duct occluder was applied to 71 patients during the study period (September 2014-August 2016), and the results were analyzed in this study. Forty-two of the patients were female and 29 male. The median age was 20.5 months (range, 6-194 months) and median weight was 16 kg (range, 6-68 kg). The PDA was classified as type A in 54 patients (76.1%), type E in 14 (19.7%), type C in 2 (2.8%) and type B in 1 (1.4%) based on the Krichenko classification. A standard ODO device was used for the transcatheter closure procedure in 66 patients and the long-shank ODO device in 5. In the echocardiographic measurement of PDA, the median smallest diameter was 2.7 mm (range, 1.5-7.0 mm), and in the angiographic measurement, the median smallest diameter was 2.5 mm (range, 1.5-6.5 mm). All 71 patients underwent successful PDA closure with the ODO. Angiography following the procedure showed complete closure in 47 patients (66.2%), mild residual shunt in 13 patients (18.3%) and a trivial shunt in 11 patients (15.5%). Color flow Doppler echocardiogpaphy at 24 h post-implantation showed that complete closure was achieved in 65 patients (91.5%), and 6 patients (8.5%) had mild residual shunt. All patients (100%) had complete closure at 30 days of follow-up. The results of this study showed that the Occlutech PDA occluder device is safe and effective in the closure of PDA. As the pulmonary artery side of the device is wider than the aortic side, protrusion toward the aortic side and embolization are prevented, but there is residual shunt in the early period, although this residual shunt disappeared after a few months.

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Long term evaluation of electromechanical delay in patients with atrial septal defect after transcatheter closure

Öz

Aruğaslan

Çınar

et al. 2018

Int J Cardiovasc Imaging

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Some studies have been showed that electromechanical delay, which may pose an increased tendency to atrial fibrillation, may prolong in patients with various clinical conditions. In addition, the electromechanical delay in patients with secundum type atrial septal defect (ASD) compared to healthy people have been reported previously. Therefore, in the present study, we prospectively evaluated the mid-term and long-term effects of the transcatheter closure of secundum type ASD on the lateral atrial conduction time (PA), septal PA, tricuspid PA, left and right intra-atrial electromechanical delay (ILeft-EMD and IRight-EMD, respectively) and inter-atrial electromechanical delay (IA-EMD) measured by means of Doppler echocardiography. Our prospective study included a total of 45 secundum type ASD patients who undergone percutaneous transcatheter closure from December 2012 to April 2015. All patients underwent transthoracic echocardiography (TTE) before the closure, at sixth and twelfth months after the closure. In comparison of the EMD sixth months after the device closure, there were statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to pre-device closure values. Twelfth months after the device closure, we also observed statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to 6-month post-device closure values. In the present study, we observed that the atrial EMD improves after device closure and continues to improve after twelfth month following post-device closure.

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Percutaneous closure of secundum atrial septal defects in pediatric and adult patients: short- and mid-term follow-up results

Abstract: Our findings showed that percutaneous closure of ASDs is successful in most patients with a low complication rate, and demonstrated that residual shunts do not develop in the majority of patients in the short- and mid-term.

Cited by 7 publications

References 18 publications

Transesophageal echocardiography and fluoroscopy for percutaneous closure of atrial septal defects

Transesophageal echocardiography and fluoroscopy for percutaneous closure of atrial septal defects

Transcatheter Closure of Patent Ductus Arteriosus in Children with the Occlutech Duct Occluder

Long term evaluation of electromechanical delay in patients with atrial septal defect after transcatheter closure

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