Should transcatheter closure of atrial septal defects with inferior-posterior deficient rim still be attempted?

Amédro, Pascal; Bayburt, Selin; Assaïdi, Anass; Kreitmann, Bernard; Habib, Gilbert; Fouilloux, Virginie; Fraisse, Alain

doi:10.21037/jtd.2019.02.89

Cited by 19 publications

(18 citation statements)

References 26 publications

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“…Cath-lab procedure with an occluder to close the defect is the standard treatment, provided there are sufficient rims around the defect and the sizes of the defects are appropriate [11]. If the rim is less than 5 mm in any aspect, it is deemed deficient and cath-lab procedure is not recommended [12], as rim deficiency is associated with significantly lower success rates [13,14]. In this case, open-heart surgery and surgical repair of the defect may have to be chosen.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Deng

Yao

Wang

et al. 2020

BMC Cardiovasc Disord

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Background: There are few reports in the literature of device closure of residual shunts following initial surgical closure of an atrial septal defect (ASD). This case study reports one such case. We describe here a case of secundum type ASD that was initially closed surgically, followed by device closure of a residual shunt with a posteroinferior deficient rim. Case presentation: A 7-month-old boy was admitted to our hospital for elective surgery to surgically correct a secundum type ASD. Unfortunately, a residual shunt 3.5 mm in diameter appeared before discharge and was enlarged at1-year follow-up. The cause of this residual shunt was dehiscence at the posteroinferior aspect, and the posteroinferior rim was 3.7 mm. After careful discussion and preparation, we proceeded with an interventional procedure. A 16 mm ASD occluder (AGA Medical Corp, Plymouth, Minnesota) was deployed successfully with no residual shunt. In some cases of ASD, interventional therapy is not considered due to the size and position of the defect, but we show here, a successful case of interventional therapy for a residual shunt with a deficient rim. Conclusion: We have presented a case in which a postoperative residual shunt with a deficient rim was successfully closed with interventional therapy.

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Section: Discussionmentioning

confidence: 99%

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Deng

Yao

Wang

et al. 2020

BMC Cardiovasc Disord

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“…Twenty-two of the procedures canceled in procedure room mainly due to total interseptum de ciency or IVC rim de ciency. Amedro P. et al (19) emphasized in their study that transcathatery closure of ASDs with posterior-inferior rim de ciency cannot be recommended.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Atrial Septal Defect in Children: Short and Long Term Follow-up Results

Ys¹,

Nişli²

2020

Preprint

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Background: Atrial septal defect (ASD) is a congenital heart disease which is usually diagnosed in childhood. However the large part of studies in literature include adults. In this study, we aimed to evaluate the follow-up results of patients who had transcatheter closure of ASD to understand the factors effected success and complications of this procedure in children. Methods: 232 patient files were evaluated retrospectively. 24 of the patients excluded from the study as the files of these patients could not be found in archive or the data needed to be evaluated was missing. Demographical data, family history, accompanying syndromes, complaints of patients, symptoms, echocardiographical (ECO) findings, transesophageal echocardiogram (TEE) findings if performed, the size of defect in balloon-sizing, the size of device used in procedure, major and minor complications evaluated. Results: In our study, 208 children [39.9% (n = 83) male, 60.1% (n = 125) female] included who were diagnosed with ASD. The mean age of the patients are 88,06 ± 56,52 months (3 days to 220 months). When the family history is examined; heart disease was not found in 87.0% (n = 181) of the patients whereas 13.0% (n = 27) of the patients had family history of heart disease. 81.7% of the patients (n = 170) had no complaint and 18.3% (n = 38) had complaints. There was a statistically significant correlation between diameter and length of defect measured with ECO, TEE and by balloon-sizing. Success rates of procedure found to be 95.7%. While the major complication of the procedure was device embolization; arrythmia was the most common minor complication. None of our patients died due to device embolization. The procedure complication rate is not statistically different according to the device type. (p = 0.075; p> 0.05) Conclusion: In our study, we found that device diameters measured by different methods correlated with each other. The procedure complication rates do not differ according to the device type. When the transcatheter ASD closure process is performed with an experienced and qualified team; mortality and morbidity rates compatible with developed countries can be achieved.

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“…Since the percentage of complications may be significant, the percutaneous closure of secundum ASD associated with posteroinferior rim deficiency should rather be avoided. 61,67 In the case of a posterior rim deficiency, the feasibility of percutaneous closure of ASD II depends on the extent of the defect. If it reaches the border with the IVC, device closure should be avoided due to the significant risk of embolization.…”

Section: Invasive Diagnostics: Heart Catheterizationmentioning

confidence: 99%

Percutaneous closure of atrial septal defect: a consensus document of the joint group of experts from the Association of Cardiovascular Interventions and the Grown-Up Congenital Heart Disease Section of the Polish Cardiac Society

et al. 2020

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communication. There are 5 types of anatomic defects known: • Secundum ASD (ASD II): 80% to even more than 90% of ASDs in the adult population; located in the fossa ovalis region and its surrounding tissue. Background information on atrial septal defect Atrial septal defect (ASD) is one of the most prevalent congenital heart defects and may frequently remain undiagnosed until adulthood. 1-4 It is a consequence of various embryological disorders that cause interatrial

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Should transcatheter closure of atrial septal defects with inferior-posterior deficient rim still be attempted?

Cited by 19 publications

References 26 publications

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Transcatheter Closure of Atrial Septal Defect in Children: Short and Long Term Follow-up Results

Percutaneous closure of atrial septal defect: a consensus document of the joint group of experts from the Association of Cardiovascular Interventions and the Grown-Up Congenital Heart Disease Section of the Polish Cardiac Society

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