Surgical Management of Complications Caused by Transcatheter ASD Closure∗

Mellert, Fritz; Cj, Preusse; Haushofer, M; Winkler, Katrin; Nill, C; Pfeiffer, Damon B.; Redel, D. A.; Lüderitz, B; Welz, A.

doi:10.1055/s-2001-19010

Cited by 15 publications

(10 citation statements)

References 6 publications

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“…To date, all devices used clinically to close ASD have had reported frame fractures, malfunctions, or abnormal configurations [1][2][3][4][5][6][7][8][9][10][11][15][16][17][18][19][20]. Systematic evaluation of these occurrences is necessary because significant complications may result [2,5,7,12,13,21]. Interestingly, however, WFF of certain devices have had very little, if any, clinical effect [1,3,4,6,[8][9][10][11].…”

Section: Discussionmentioning

confidence: 98%

“…Based on the theoretic risks of thrombus formation, incomplete endotheliazation or right atrial disk embolization, the decision was made to remove the device. As with all ASD closure devices with WFF or other loss of structural integrity, there is a risk of embolization [5,7,[12][13][14], not only of the entire device, but also portions or fragments of the device. Device embolization did not occur with WFF of the HELEX.…”

Section: Discussionmentioning

confidence: 98%

“…The HELEX is not only a more soft, compliant ASD closure device than most others, but perhaps the occurrence of WFFs allows the ''device to conform to the heart'' rather than forcing the ''heart to conform to the device''. Most other ASD closure devices have caused cardiac erosions or fistula [5,7,13,[21][22][23][24][25][26][27]. To date, with world-wide use of the HELEX there has not been a single reported cardiac perforation or erosion of the aortic root or atrial free wall.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Fracture of the GORE HELEX septal occluder: Associated factors and clinical outcomes

Fagan

Dreher

Cutright

et al. 2009

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Fracture of the GORE HELEX septal occluder: Associated factors and clinical outcomes

Fagan

Dreher

Cutright

et al. 2009

Cathet Cardio Intervent

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“…Em 1997, Sharafuddin et al 9 apresentaram os resultados iniciais de uma prótese com componente único, autocentrável e autoexpansível, com a qual se obteve grande melhora das taxas de sucesso, redução das complicações e melhores resultados a longo prazo. O mais importante é que esse dispositivo, por suas características de construção, permitiu ampliar a utilização da técnica para a maioria dos porta- Complicações imediatas, como perfuração cardía-ca 22 , bloqueio atrioventricular transitório 23 , embolização do dispositivo 24,25 ou arritmias mais graves, são raras e intimamente relacionadas a curva de aprendizado do operador e seleção adequada do tamanho do dispositivo. Dentre vários autores, as complicações imediatas reportadas são inferiores a 10%, e não são relatados óbitos.…”

Section: Tratamento Percutâneo Das Comunicações Interatriaisunclassified

Oclusão percutânea de comunicação interatrial pelo sistema único de saúde: uma opção economicamente viável

Filho¹,

Mânica²,

Cardoso³

2010

Rev. Bras. Cardiol. Invasiva

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A comunicação interatrial (CIA) é uma das malformações congênitas mais frequentes, representando aproximadamente 5% a 10% de todos os defeitos cardíacos congêni-tos. O tipo mais comum é a CIA ostium secundum (CIA OS), que representa cerca de 75% dessas malformações. Quando descoberta tardiamente ou na ausência de tratamento, além da alteração no exame clínico, pode existir insuficiên-cia cardíaca, arritmias cardíacas, insuficiência mitral, sobrecarga ventricular direita e hipertensão pulmonar. Em casos avançados com hipertensão pulmonar grave e reversão do shunt interatrial (direita para esquerda) instala-se a cianose, o que indica doença cardiopulmonar grave e mortalidade aumentada. Nas últimas décadas, com o aprimoramento das técnicas e dos dispositivos percutâneos, as possibilidades de tratamento dos defeitos congênitos por via percutânea têm crescido vertiginosamente. Vários estudos já demonstraram os excelentes resultados imediatos e a longo prazo da atriosseptoplastia percutânea. Além de proporcionar maior conforto ao paciente, menores taxas de complicações, menor tempo de recuperação intra e extra-hospitalar e eficácia similar à da atriosseptoplastia cirúrgica, em países desenvolvidos, é comprovadamente a opção mais econômica. Não há dúvidas de que, em futuro próximo, a relação custoefetividade desse procedimento será observada também em países em desenvolvimento como o Brasil, em que o custo da prótese, ainda hoje, é o principal obstáculo para a padronização desse procedimento, e em que os valores pagos pelos procedimentos cirúrgicos continuam muito defasados. DESCRITORES:Comunicação interatrial. Cardiopatias congênitas. Próteses e implantes. ABSTRACT Percutaneous Closure of Atrial Septal Defects by the Brazilian Health System: an Economically Feasible OptionAtrial septal defect (ASD) is one of the most frequent congenital malformations, representing 5% to 10% of all congenital heart defects. The most common type is the ostium secundum ASD (OS ASD), and represents 75% of these malformations. When diagnosed late or left untreated, in addition to abnormalities in the clinical examination, there may be heart failure, cardiac arrhythmias, mitral insufficiency, right ventricular overload and pulmonary hypertension. In advanced cases with severe pulmonary hypertension and interatrial shunt reversal (right to left), there is cyanosis, which indicates severe cardiopulmonary disease and increased mortality. In the last decades, with the improvement of percutaneous techniques and devices, the possibility of percutaneous treatment of congenital defects has increased dramatically. Several studies have shown excellent early and long-term results of percutaneous atrial septoplasty. In addition to providing greater comfort for patients, lower complication rates, less in-hospital and extra-hospital recovery time and efficacy similar to that of surgical atrial septoplasty in developed countries, it is definitely the most economic option. There is no doubt that in the near future, the cost-effectiveness ratio of this proc...

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“…This mass presented as an oscillating echo free area surrounded by a membrane attached to the device by a thin stalk. [1][2][3] The detection and correct classification of intracardiac masses, including tumors and thrombi, are facilitated with the use of echocardiographic contrast agents. It was assumed that the content of the echo free mass had already emptied into the left atrium.…”

mentioning

confidence: 99%

Late Infective Endocarditis of an Atrial Septal Occluder Device Presenting as a Cystic Mass

Walpot¹,

Amsel²,

Rodrigus³

et al. 2011

Echocardiography

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We report an atypical echocardiographic presentation of a vegetation in a patient with late infective endocarditis of an atrial septal defect (ASD) occluder device. Transesophageal echocardiography demonstrated a penduculated mass attached to the left atrial side of the occluder device. This mass presented as an oscillating echo free area surrounded by a membrane attached to the device by a thin stalk. At time of surgical excision, the lesion did not present as a spherical cyst. It was assumed that the content of the echo free mass had already emptied into the left atrium. Histopathology diagnosed the mass as a vegetation. The contribution of contrast echocardiography to the evaluation of intracardiac masses is briefly discussed.

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Surgical Management of Complications Caused by Transcatheter ASD Closure∗

Abstract: Transcatheter closure of uncomplicated ASD is a feasible alternative but surgical stand-by is essential. Nevertheless more complicated ASD should be operated, especially since the cosmetically satisfactory techniques of minimal invasive heart surgery are available.

Cited by 15 publications

References 6 publications

Fracture of the GORE HELEX septal occluder: Associated factors and clinical outcomes

Fracture of the GORE HELEX septal occluder: Associated factors and clinical outcomes

Oclusão percutânea de comunicação interatrial pelo sistema único de saúde: uma opção economicamente viável

Late Infective Endocarditis of an Atrial Septal Occluder Device Presenting as a Cystic Mass

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