Transcatheter Closure of Complex Atrial Septal Defects

Rao, P. Syamasundar

doi:10.1111/echo.12742

Cited by 6 publications

(4 citation statements)

References 38 publications

(48 reference statements)

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“…Complex defects, namely large defects, small septal rims, multiple defects, and septal aneurysms are problematic, and suitable modifications in the technique should be embarked upon to guarantee success of the device implantation, as detailed elsewhere 26 , 27 .…”

Section: Ostium Secundum Asdsmentioning

confidence: 99%

Recent advances in managing septal defects: atrial septal defects

Rao

Harris

2017

F1000Res

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The purpose of this review is to discuss the management of atrial septal defects (ASD), paying particular attention to the most recent developments. There are four types of ASDs: ostium secundum, ostium primum, sinus venosus, and coronary sinus defects. The fifth type, patent foramen ovale—which is present in 25 to 30% of normal individuals and considered a normal variant, although it may be the seat of paradoxical embolism, particularly in adults—is not addressed in this review. The indication for closure of the ASDs, by and large, is the presence of right ventricular volume overload. In asymptomatic patients, the closure is usually performed at four to five years of age. While there was some earlier controversy regarding ASD closure in adult patients, currently it is recommended that the ASD be closed at the time of presentation. Each of the four defects is briefly described followed by presentation of management, whether by surgical or percutaneous approach, as the case may be. Of the four types of ASDs, only the ostium secundum defect is amenable to percutaneous occlusion. For ostium secundum defects, transcatheter closure has been shown to be as effective as surgical closure but with the added benefits of decreased hospital stay, avoidance of a sternotomy, lower cost, and more rapid recovery. There are several FDA-approved devices in use today for percutaneous closure, including the Amplatzer® Septal Occluder (ASO), Amplatzer® Cribriform device, and Gore HELEX® device. The ASO is most commonly used for ostium secundum ASDs, the Gore HELEX® is useful for small to medium-sized defects, and the cribriform device is utilized for fenestrated ASDs. The remaining types of ASDs usually require surgical correction. All of the available treatment modes are safe and effective and prevent the development of further cardiac complications.

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Section: Ostium Secundum Asdsmentioning

confidence: 99%

Recent advances in managing septal defects: atrial septal defects

Rao

Harris

2017

F1000Res

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“…Indeed, previous research has shown the application of TTE guidance for transcatheter closure of ASDs . The role of an alternative noninvasive approach with on‐site transthoracic echocardiography (TTE) to monitor and guide the catheterization procedure remains unclear.…”

mentioning

confidence: 99%

“…19 Indeed, previous research has shown the application of TTE guidance for transcatheter closure of ASDs. 20,21 The role of an alternative noninvasive approach with on-site transthoracic echocardiography (TTE) to monitor and guide the catheterization procedure remains unclear. The safety, ability to determine defect size, and efficacy of TTE for guiding ASD closure are, however, not been well accepted.…”

mentioning

confidence: 99%

Efficacy and Safety of Transthoracic Echocardiography Alone in Transcatheter Closure of Secundum‐Type Atrial Septal Defects in Adults

et al. 2015

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“…Management of complex ASDs, defined as large defects (> 26 mm by balloon-sizing), deficient septal rims, multiple or fenestrated defects, and/or atrial septal aneurysms, was reviewed with the resulting conclusion that the majority of complex ASDs can be closed by utilizing either conventional or special techniques and/or devices [25,[28][29][30][31]. However, ASDs with deficient or absent postero-inferior rim continue to be challenging.…”

Section: Atrial Septal Defectsmentioning

confidence: 99%

Evolution of Pediatric Cardiology over the Last 50 Years - Part II

Syamasundar¹

2021

Int J Clin Cardiol

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Check for updatesdevice. A methodical assessment of all three cohorts of the buttoned device suggested progressive decrease in complications rates, including unbuttoning and better implantation feasibility while preserving the effective occlusion rates with consecutive re-designed versions of the buttoned device [17,18,23]. The author's experience with Amplatzer Septal Occluder (ASO) was then reviewed with the conclusion that ASD occlusion with ASO is feasible, safe and effective in most types of ostium secundum ASD cases with occasional complications [9,10,24]. Initially, the ASO device characteristics were described followed by presentation of indications for device closure, the technique of device implantation, and results (Figure 4).The author and his associates performed the closure of more than 100 ostium secundum ASDs with the ASO as of 2011. The initial series of patients was presented in a poster format [24]. Sixty-five patients were taken to the catheterization laboratory with the intent to occlude their ASDs with the ASO during 2003 to 2011. Devices were not implanted in 4 (6%) patients because of flail or inadequate septal rims. In the remaining 61 patients, transcatheter occlusions were performed with the device. The ages of the patients varied between 3.1 and 17 years (mean 7.9 years). The weights of the patients ranged between 11.8 and 69 kg with a mean of 29.6 kg. Twenty-four were boys and 42 were girls. The Qp: Qs was 0.9 to 4.5 with a mean of 1.8. The ASD diameter measured by TEE varied between 5.6 and 29.5 mm with a mean of 14 mm. The ASD diameter measured by

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Transcatheter Closure of Complex Atrial Septal Defects

Cited by 6 publications

References 38 publications

Recent advances in managing septal defects: atrial septal defects

Recent advances in managing septal defects: atrial septal defects

Efficacy and Safety of Transthoracic Echocardiography Alone in Transcatheter Closure of Secundum‐Type Atrial Septal Defects in Adults

Evolution of Pediatric Cardiology over the Last 50 Years - Part II

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