Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country

Siddiqui, Waleed Tariq; Tariq, Usman; Atiq, Mehnaz; Amanullah, Muhammad Muneer

doi:10.15171/jcvtr.2014.013

Cited by 17 publications

(12 citation statements)

References 24 publications

(22 reference statements)

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“…Although we found that surgical costs were on average lower than trans catheter costs, this difference is various in hospitals and countries, and was sometimes viseversa. In some studies from developing countries such as Pakistan and Iran surgical costs were on average lower than trans catheter costs,9, 10, 16 and in most studies from developed countries, surgical costs were on average higher than trans catheter costs 8, 15. Hospitalization days and hoteling costs are significantly lower in developing countries.…”

Section: Discussionmentioning

confidence: 97%

“…Conversely, there were controversies about hospital costs8, 9, 10 and complete closure 11 . Also surgical closure of ASD is technically simple and does not require specialized long-term follow-up but operator’s experience is important factor for successful device closure and after trans catheter closure, patients should remain under permanent surveillance to detect potentially serious long-term complications 11, 12…”

Section: Introductionmentioning

confidence: 99%

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Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Askari

Soraya

Ayremlu

et al. 2018

The Egyptian Heart Journal

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ObjectivesAtrial Septal Defect (ASD) accounts for 10% of congenital cardiac defects. The purpose of this retrospective study was to compare the short-term outcomes of surgical versus trans catheter closure of secundum atrial septal defect.MethodsThis is a single-center retrospective cohort study in patients who had surgical or trans catheter ASD closure. ASD closure outcomes such as hospital cost, length of hospital and ICU stay, residual ASDs, complications, readmission, hospital and three month mortality were recorded and compared.ResultsBetween March 2010 and March 2016, total of 102 secundum ASD patients were treated in our center (71 patients surgical ASD closure and 31 patients trans catheter ASD closure). About 13.9% of patients (5/36) in the device group had failed procedural attempt for various reasons and these patients underwent surgery closure. Complete closure was observed in 26 of 31 patients (83.9%) in the device group and in 70 of 71 patients in the surgery group (98.6%). The mean length of hospital stay was 5.56 days for surgical group and 2.06 days for device group. The procedure cost for surgery was found to be 5.7% lower than trans catheter closure (patient payment). The complication rates were 18.3% for surgical group and 25.8% for the device group. Readmission after discharge was more common in surgery group (11.2 vs 6.4%). Hospital and three months mortality in both groups were zero.ConclusionsBoth trans catheter and surgical procedure are good methods of successful ASD closure. Considering that the surgical group patients were higher risk patients, mean total hospital cost of patient's procedures were significantly higher in device closure group, failed intervention rate and residual ASD were more common in device group and complications of device group were more serious; thus, appropriate patient selection is an important factor for successful device closure.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Askari

Soraya

Ayremlu

et al. 2018

The Egyptian Heart Journal

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“…In our study subjects the 60 patients undergoing the procedure had no reported complications with an average duration of hospital stay of 26±2 hours which is greatly below the expected duration of hospital stay after surgical closure of ASD type II. 14 There is conflicting data on the duration needed for gradual reverse remodeling of RV in patients after Transcatheter closure of ASD type II. Many papers have focused on this issue from different aspects.…”

Section: Discussionmentioning

confidence: 99%

Biventricular reverse remodeling and relationship with mitralvalve prolapse after transcatheter closure of ASD secundum, a 3Dechocardiographic study

El-Sisi

Dabour

Fattouh

et al. 2019

J Cardiovasc Thorac Res

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Introduction: Mitral valve prolapse (MVP) is the most common anomaly of the mitral valve. Several studies have shown prevalence of MVP in atrial septal defect (ASD) especially secundum types (II). The aims of this study is to show the potential role of 3D echocardiography in improving the diagnosis of MVP and to depict the relationship between reverse remodeling of the right and left ventricles (RV, LV) and MVP after transcatheter closure of ASD II. Methods: Sixty patients underwent transcatheter closure of ASD II and completed follow up by 2D and 3D echocardiography in Cairo University Children Hospital before the procedure and at 24 hours, 1 and 6 months after the procedure. Results: 3D echocardiography was more accurate than 2D echocardiography in detecting MVP frequency in ASD II patients (75% vs. 50%). Maximum statistically significant remodeling was detected by 3D echocardiography 1 month after the procedure (RV: LV ratio by 3D echocardiography 1.9±0.03 24 hours after the procedure vs. 1.6±0.03 1 months after the procedure, P < 0.01) while 2D echocardiography was delayed in detecting biventricular reverse remodeling. 3D derived RV: LV ratio was accurate in detecting MVP status with a sensitivity of 88%.

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“…1,4 The current standard of care for selected cryptogenic stroke patients with PFO is a transcatheter closure (TC) procedure, where a double disk occlusion device is implanted into the septum. 5,6 Due to its minimally invasive nature and support from randomized controlled trials (RCTs) for decreasing the risk of repeat stroke and other adverse cardiovascular outcomes, implantation of transcatheter devices is widely considered to be a safe, effective, and economical option for PFO closure. 1,4,7,8 Given that much of the widespread implementation of transcatheter closure is based upon RCTs, there is a growing interest in the evaluation of real world long-term post-closure outcomes using population-level observational data.…”

Section: Introductionmentioning

confidence: 99%

Developing A Random Forest Algorithm to Identify Patent Foramen Ovale and Atrial Septal Defects in Ontario Administrative Databases

Oliva

Horlick

Wang

et al. 2021

Preprint

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Purpose: Routinely collected administrative data is widely used for population-based research. However, although clinically very different, atrial septal defects (ASD) and patent foramen ovale (PFO) share a single diagnostic code (ICD-9: 745.5, ICD-10: Q21.1). Using machine-learning based approaches we developed and validated an algorithm to differentiate between PFO and ASD patient populations within healthcare administrative data. Methods: Using data housed at ICES, we identified patients who underwent transcatheter closure in Ontario between October 2002 and December 2017 using a code (1HN80GPFL, N = 4680). A novel random forest model was developed using demographic and clinical information. Those patients who had undergone transcatheter closure and had records in the CorHealth Ontario cardiac procedure registry (N = 1482) were used as the reference standard. Several algorithms were tested and evaluated for accuracy, sensitivity, and specificity. Variable importance was examined via mean decrease in Gini index. Results: We tested 7 models in total. The final model included 24 variables, including demographic, comorbidity, and procedural information. After hyperparameter tuning, the final model achieved 0.76 accuracy, 0.76 sensitivity, and 0.75 specificity. Patient age group had the greatest influence on node impurity, and thus ranked highest in variable importance. Conclusions: Our random forest classification method achieved reasonable accuracy in identifying PFO and ASD closure in administrative data. The algorithm can now be applied to evaluate long term PFO and ASD closure outcomes in Ontario. Future external validation studies are recommended to further test the algorithm.

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Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country

Cited by 17 publications

References 24 publications

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Biventricular reverse remodeling and relationship with mitralvalve prolapse after transcatheter closure of ASD secundum, a 3Dechocardiographic study

Developing A Random Forest Algorithm to Identify Patent Foramen Ovale and Atrial Septal Defects in Ontario Administrative Databases

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