Time-course of cardiac remodeling following transcatheter closure of atrial septal defect

Pascotto, Marco; Santoro, Giuseppe; Cerrato, Fabiana; Caputo, Salvatore; Bigazzi, Maurizio Cappelli; Iacono, Carola; Carrozza, Marianna; Russo, Maria Giovanna; Caianiello, Giuseppe; Calabrò, Raffaele

doi:10.1016/j.ijcard.2005.10.008

Cited by 76 publications

(91 citation statements)

References 23 publications

(15 reference statements)

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“…[44][45][46][47] Essas alterações atingem valores dentro da normalidade na maioria dos pacientes em até um mês após o procedimento percutâneo. 48 Entretanto, séries de pacientes submetidos a reparo cirúrgico são controversas quanto a esse processo, mesmo após alguns anos do procedimento. Isso ocorre possivelmente pelos efeitos deletérios da circulação extracorpórea e do clampeamento aórtico, como isquemia miocárdica temporária, e da pericardiotomia, levando a aderên-cias pericárdicas.…”

Section: Base Racional Para Utilização Da Tecnologiaunclassified

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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Section: Base Racional Para Utilização Da Tecnologiaunclassified

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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“…Thus, reduction in PAP and right heart cavity dimensions is established [4,20,21]. Previous studies have shown a significant cardiac remodeling early after percutaneous ASD closure [2,3]. In our study, we compared ECG, echocardiographic parameters before device closure, 1 month and 1 year after closure.…”

Section: Discussionmentioning

confidence: 96%

“…Although surgical closure of secundum type ASD has been considered the standard treatment for more than 45 years with very low rate of complication [17], trans-catheter ASD closure has become an important alternative to surgical repair with an excellent outcome [3,18].…”

Section: Discussionmentioning

confidence: 99%

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Intermediate Outcome of Transcatheter Closure of Secundum Atrial Septal Defect on Cardiac Remodeling in Egyptian Children and Adults

Ammar¹,

Arab²,

Hammady³

et al. 2016

JCCR

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Background: Atrial septal defects (ASDs) are the second most common congenital lesion in adults. ASD closure is followed by symptomatic improvement and regression of pulmonary artery pressure (PAP), reduction in right heart volume overload and hence the prevalence of arrhythmias, thus quantification of the RV function is an important prognostic factor. Tissue Doppler and strain imaging are helpful tools for the assessment of RV systolic and diastolic function. Results:At the 1 year follow up of transcatheter ASD closure, the RVEDD had decreased from 22.93±5.889 mm to 18±4.06 mm(P=0.000), and the LVEDD had increased from 33.23±5.393 mm to 36.27±6.75 mm(P=0.001). Mean PAP decreased from 18.37±4.796 mmHg to 14.77±4.75 mmHg (P=0.022). RVSP decreased from 28.9±4.425 mmHg to 15.83±4.17 mmHg (P=0.000). Regarding electrocardiography, the P wave duration decreased from 107.13±19.62 ms to 77±14.18 ms (P=0.000) and the PR interval decreased from 177.97±21.932 ms to 160.33±26.06 ms (P=0.000).The QRS duration decreased from 134.40± 4.97 ms to a mean of 119.87±4.12 ms (P=0.000). All the patients had normal sinus rhythm before closure and no one developed arrhythmia until 1 year after closure. 50 % of the patients had normal RV size at the 1-year follow up. Tricuspid annular velocities, longitudinal strain, and strain rate measurement showed no significant difference as compared to normal values, which suggest improvement of the RV systolic and diastolic function after transcatheter closure. Conclusion:Transcatheter ASD closure leads to a significant improvement in heart cavity dimensions and RV function and reversal of electrical and mechanical changes. Novel parameters for assessment of RV function are promising and appear to be helpful for the assessment of RV function and its response to correction of volume

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“…Although a significant number of patients with ASD remain asymptomatic until adult age, early diagnosis and treatment of this disease is crucial because they lead to right atrial and ventricular volume load, systemic embolism, arrhythmias, and paradoxic embolism (3,4). There are several different types of ASD: the secundum ASD (75% of ASDs; located in the region of the fossa ovalis and its surrounding), the primum ASD (15% to 20% of ASDs) positioned inferiorly near the crux of the heart, the sinus venosus ASD (5% to 10% of ASDs) located near the superior vena cava entry or near the inferior vena cava entry, and the uncommon coronary sinus septal defect (less than 1% of ASDs), which causes shunting through the ostium of the coronary sinus (7).…”

Section: Introductionmentioning

confidence: 99%

Indications for Percutaneous Closure in Adult Congenital Heart Defect

Kaya

Ardıç

2013

ELECTRON J GEN MED

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Time-course of cardiac remodeling following transcatheter closure of atrial septal defect

Cited by 76 publications

References 23 publications

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

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

Intermediate Outcome of Transcatheter Closure of Secundum Atrial Septal Defect on Cardiac Remodeling in Egyptian Children and Adults

Indications for Percutaneous Closure in Adult Congenital Heart Defect

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