Transcatheter versus Surgical Closure of Secundum Atrial Septal Defect in Adults: Impact of Age at Intervention. A Concurrent Matched Comparative Study

Rosas, Martı́n; Zabal, Carlos; García-Montes, José Antonio; Buendı́a, Alfonso; Webb, Gary D.; Attié, Fause

doi:10.1111/j.1747-0803.2007.00091.x

Cited by 42 publications

(26 citation statements)

References 33 publications

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“…This is supported by a recent multicenter case series from the C3PO registry, which reports similarly high risk for new arrhythmia (2.4 vs. 2.0% in the current series), embolization (1.5 vs. 1.9% in this series), and major adverse events (4.7 vs. 4.1% in this series) . It is important to emphasize that in series with simultaneous measurement of adverse outcomes between surgical and device closure of ASD, transcatheter closure has performed at least as well as surgery regardless of the era in which data were recorded .…”

Section: Discussionsupporting

confidence: 77%

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The influence of deficient retro‐aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects

O’Byrne

Gillespie

Kennedy

et al. 2016

Cathet Cardio Intervent

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Background Concern regarding aortic erosion has focused attention on the retro-aortic rim in patients undergoing device closure of atrial septal defects (ASD), but its effect on early outcomes is not well studied. Methods A multi-center retrospective cohort study of patients undergoing device occlusion of ASD between 1/2011–10/2014 was performed, using data from the IMproving Pediatric and Adult Congenital Treatment Registry. Subjects were divided between those with retro-aortic rim <5 and ≥5 mm. Primary outcomes were technical failure and major early adverse events. Case times were measured as surrogates of technical complexity. The effect of deficient retro-aortic rim on primary outcomes was assessed using hierarchical logistic regression, adjusting for other suspected covariates and assessing whether they represent independent risk factors Results 1,564 subjects (from 77 centers) were included, with deficient retro-aortic rim present in 40%. Technical failure occurred in 91 subjects (5.8%) and a major early adverse event in 64 subjects (4.1%). Adjusting for known covariates, the presence of a deficient retro-aortic rim was not significantly associated with technical failure (OR: 1.3, 95% CI: 0.9–2.1) or major early adverse event (OR: 0.7, 95% CI: 0.4–1. 2). Total case (p=0.01) and fluoroscopy time (p=0.02) were greater in subjects with deficient rim, but sheath time was not significantly different (p=0.07). Additional covariates independently associated with these outcomes were identified. Conclusion Deficient retro-aortic rim was highly prevalent but not associated with increased risk of technical failure or early adverse events. Studies with longer follow-up are necessary to assess other outcomes, including device erosion.

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Section: Discussionsupporting

confidence: 77%

“…A potential concern raised by this analysis is that the rates of technical failure and major early adverse event rates are higher than previously reported . Definitions of technical failure and major early adverse outcomes were chosen to be sensitive.…”

Section: Discussionmentioning

confidence: 99%

The influence of deficient retro‐aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects

O’Byrne

Gillespie

Kennedy

et al. 2016

Cathet Cardio Intervent

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“…The long-term outcomes of this relatively recently introduced treatment method remain to be clarifi ed. [9][10][11][12][13] Unlike transcatheter treatment, robotic surgery allows for closure of nonsecundum type ASDs, such as primum type or sinus venosus defects, as well as closure of multiple defects. The surgeon is also able to patch a defect even without a suffi cient amount of septal tissue around the defect to fi rmly fi x an occluder.…”

Section: Discussionmentioning

confidence: 99%

Totally endoscopic closure of an atrial septal defect using the da vinci surgical system: Report of four cases

et al. 2010

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This report presents four cases of totally endoscopic closure of an atrial septal defect using the da Vinci Surgical System (Intuitive Surgical, Mountain View, CA, USA). The patients were diagnosed with an ostium secundum atrial septal defect and elected to undergo minimally invasive surgery. A cardiopulmonary bypass was established via cannulation of the femoral vessel and jugular vein, and blood cardioplegic arrest was induced using a transthoracic cross-clamp. The mean extracorporeal circulation and cardiac arrest times were 86 +/- 21 and 22 +/- 8 min, respectively. No patient experienced pain after surgery, and all were fast-tracked for early discharge and released on postoperative day 3. No intraoperative or postoperative complications occurred. This procedure permitted a short hospital stay, quick return to an active lifestyle, and had an excellent cosmetic outcome. The success of this procedure therefore encourages that this procedure should be considered as day surgery.

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“…14,38,39 The clinical outcomes in 54 patients with moderate or severe pulmonary arterial hypertension who underwent successful device implantation for ASD-II closure have been recently examined by the group in Toronto. 40 During early follow-up, all patients were alive and the RV systolic pressure decreased significantly.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Outcomes After Transcatheter ASD Closure

Peirone

Pedra

2013

Interventional Cardiology Clinics

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Transcatheter versus Surgical Closure of Secundum Atrial Septal Defect in Adults: Impact of Age at Intervention. A Concurrent Matched Comparative Study

Cited by 42 publications

References 33 publications

The influence of deficient retro‐aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects

The influence of deficient retro‐aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects

Totally endoscopic closure of an atrial septal defect using the da vinci surgical system: Report of four cases

Outcomes After Transcatheter ASD Closure

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