Transcatheter closure of atrial septal defects using the Cardio-Seal implant

Pedra, Carlos Augusto Cardoso; Pihkala, Jaana; Lee, K.-J.; Boutin, Christine; Nykanen, David; McLaughlin, Peter R.; Harrison, David A; Freedom, R. M.; Benson, Lee

doi:10.1136/heart.84.3.320

Cited by 79 publications

(57 citation statements)

References 18 publications

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“…Broken arms, however, were also reported for this new device. 10 Unacceptable detachment between occluder and counter-occluder were reported in the buttoned device, 12 and the AngelWings device was not retrievable into the sheath after delivering into the right atrium. Surgical intervention is needed when problems develop with these devices.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Atrial Septal Defects With the Amplatzer Septal Occluder. A Japanese Clinical Trial.

Oho

Ishizawa

Akagi

et al. 2002

Circ J

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Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Atrial Septal Defects With the Amplatzer Septal Occluder. A Japanese Clinical Trial.

Oho

Ishizawa

Akagi

et al. 2002

Circ J

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“…Further, it is convenient to convert to a CPB operation in case of emergency events. Sixth, the approach is inexpensive (Pedra et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Transthoracic closure of atrial septal defect and ventricular septal defect without cardiopulmonary bypass

Lee

et al. 2015

Genet. Mol. Res.

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ABSTRACT. The minimally invasive surgical transthoracic occlusion of an atrial septal defect (ASD) or a ventricular septal defect (VSD) is an increasingly widespread alternative treatment for congenital heart disease. The aim of this study is to summarize our clinical experience with minimally invasive surgical transthoracic occlusion of ASD and VSD without cardiopulmonary bypass (CPB). Between April 2011 and October 2012, 27 patients with ASD and 95 patients with VSD (78 men and 44 women) were considered for minimally invasive surgical transthoracic occlusion without CPB. A small infrasternal incision (2.0-4.0 cm) was made under general anesthesia, under transesophageal echocardiography (TEE) guidance; the ASD and VSD were closed by using an appropriate occluder; and TEE was performed simultaneously to demonstrate the position of the device, any residual shunting, or encroachment on the atrioventricular valve, coronary sinus, or aortic valve. Successful transthoracic occlusion was performed in all 122 3761 ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 3760-3766 (2015) Minimally invasive surgical transthoracic occlusion patients without complications. No complications such as thirddegree atrioventricular block and residual shunting occurred after the procedures. The ventilation time was 2.2 ± 1.2 h, and the average length of hospital stay was 4.7 ± 1.7 days. All patients received aspirin at 3 mg·kg -1 ·day -1 (maximum 100 mg/day) 24 h after the procedure. Minimally invasive surgical transthoracic occlusion without CPB is a new treatment that has many advantages such as causing little trauma, promoting quick recovery, having less complications, and avoiding radiation damage. However, the appropriate selection of patients is still key to improving the success rate of the operation.

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“…ASD device closure usually is a procedure of choice for ASD secondom when the patient has good rims and files full the criteria for that [8][9][10] rhythm disturbance is very rare complication of this procedure [7], and usual common in small children who has large defects need large device for suitable closure. Patient who needs device size ≥ 18 mm and device / patient height ratio > 0.18 are Carrie the higher risk factors.…”

Section: Discussionmentioning

confidence: 99%

Heart Block After ASD Device Closure

Alsoufi¹

2014

JCCR

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4 years old boy with weight of 10.5 Kg and height of 100 cm, he is known case of moderate to large ASD secondum with recurrent chest infections and failure to thrive under treatment with frosimed and close follow up in the clinic. Cardiovascular examination reviled: normal S1+fixed and splitting of S2+ejection systolic murmur at left upper sternal border, per-procedure electrocardiogram showed normal sinus rhythm with heart rate 95-100/min ,incomplete right bundle brunch block. His echocardiography reviled large ASD secondum of 15-16 mm with adequate SVC, IVC and aortic rims and slightly short AV valve rim associated with dilated right atrium and ventricle with sings of increased pulmonary blood flow. During cardiac catheterization under general anesthesia and transesophaygeal echocardiography guidance we confirmed the accurate size of the defect and decided to precede and close this ASD by 18 mm Amplatzer septal occluder (the device/height ratio is : 0.18 )The procedure went smoothly without any complications in the cath lab and the patient was observed in the recovery area then in PICU with stable vital sings, sinus rhythm around 99-101/ min and after 24 h of the closure electrocardiography showed normal sinus rhythm with same degree of PRBBB ( Figure 1). Echocardiography showed big ASD device insite without any residual shunt or interacting with adjacent structures ( Figure Heart Block After ASD Device Closure 2).Patient was discharged home on aspirin 50 mg daily and given appointment after one week for follow up in the clinic. After one week he came to pediatric cardiology for follow up, he was asymptomatic with no complain, his heart rate was 66/min with regular rhythm, other vital signs were stable. Echocardiography at that time showed ASD device in good position without any residual shunt or interfering with A-V valves or other structures. His ECG showed dominant sinus rhythm with HR = 66/min , prolonged PR interval l0.18 -0.2 sec (first degree heart block) and occasional 2:1 heart block ( Figure 3). 24 hour holter monitor also confirm the finding of first degree heart block with occasional second degree as 2:1 but no escape rhythm or long pauses. The parents refused the admission for observation and they preferred to come daily for close follow up so we started him on oral prednisolone 1 mg/kg/day with ECG monitoring every 2 days. After 5 days from this plan the patient remain stable with no complain but his ECG showed normal sinus rhythm with shorter PR interval 0.16 -0.17 sec and no signs of heart block (recovered normal sinus rhythm) (Figure 4). 24 hour holter monitor also confirm the normal sinus rhythm without any arrhythmias so we stopped the prednisolone and kept him under observation every week with new ECG.After one month he was stable,no complains and started to gain some weight on aspirin only.ECG at that time showed normal sinus rhythm with normal PR interval 0.16 sec and no signs of heart block ( Figure 5). Echocardography revealed the device inn place, no residual shunt, no interfering wi...

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Transcatheter closure of atrial septal defects using the Cardio-Seal implant

Cited by 79 publications

References 18 publications

Transcatheter Closure of Atrial Septal Defects With the Amplatzer Septal Occluder. A Japanese Clinical Trial.

Transcatheter Closure of Atrial Septal Defects With the Amplatzer Septal Occluder. A Japanese Clinical Trial.

Transthoracic closure of atrial septal defect and ventricular septal defect without cardiopulmonary bypass

Heart Block After ASD Device Closure

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