Transient heart block following patent foramen ovale and atrial septal defect closure with gore cardioform devices

We present the results of the first morphological study of a Gore® HELEX® Septal Occluder 30 mm that was explanted seven years after interventional implantation due to a significant left-to-right shunt (7 mm) which resulted from the stretching of the concomitant patent foramen ovale by the occluder after atrial septal defect closure. Complete endothelialization of the surface of the device, the formation of the connective tissue around the implant, minor chronic inflammation, the appearance of foreign body giant cells and weakened myocardial cells adjacent to the implant as well as enhanced expression of matrix metalloproteinases were demonstrated.

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Geography or pathology? Regional variation in atrial septal defect closure rates and techniques

Cardiology in the Young ◽

10.1017/s1047951111000618 ◽

2011 ◽

Vol 21 (5) ◽

pp. 577-584 ◽

Cited By ~ 2

Author(s):

Wendy L. Walker ◽

Tara Karamlou ◽

Brian S. Diggs ◽

Eric I. Ehieli ◽

Kirk A. Caddell ◽

...

Keyword(s):

Atrial Septal Defect ◽

Patent Foramen Ovale ◽

Septal Defect ◽

Practice Patterns ◽

The United States ◽

Foramen Ovale ◽

Atrial Septal Defect Closure ◽

Closure Rate ◽

Surgical Closure ◽

Hospital Referral

AbstractBackgroundSince the introduction of percutaneous closure in the United States, rates of secundum atrial septal defect and patent foramen ovale closures have increased substantially. Whether or not closure rates are uniform or vary due to differences in regional practice patterns is unknown. We sought to investigate this by comparing regional rates of closure across Florida.MethodsWe identified all atrial septal defect closures from 2001 to 2006 in the Florida State Inpatient Database. Using small area analysis, zip codes were assigned to Hospital Referral Regions based on where patients were most likely to go for closure. We obtained population-normalised rates of overall, percutaneous, and surgical closure.ResultsOf 1830 atrial septal defect and patent foramen ovale closures from 2001 to 2006, 751 were surgical and 1004 were percutaneous. The statewide closure rate was 1.91 per 100,000 people per year; regional rates varied 3.8-fold from 0.78 to 2.94 per 100,000 people per year. Percutaneous rates varied sevenfold from 0.25 to 1.75 per 100,000 people per year, while surgical rates varied 2.71-fold from 0.53 to 1.44 per 100,000 people per year.ConclusionsDespite a consistent prevalence of atrial septal defects, and patent foramens ovale, rates of repair vary across regions, suggesting that closure is driven by provider practice patterns rather than patient pathology. Efforts should be directed towards increasing consensus regarding the appropriate, evidence-based indications for closure so as to avoid the costs and potential negative sequelae of over- or undertreatment.

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Prominent Eustachian Valve and Atrial Septal Defect Presenting With Chronic Hypoxemia in a Teenager

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120917154 ◽

2020 ◽

Vol 11 (5) ◽

pp. 666-668

Author(s):

Daphney Kernizan ◽

Rami Kharouf ◽

Bradley Robinson ◽

Wolfgang Radtke

Keyword(s):

Atrial Septal Defect ◽

Left Atrial ◽

Patent Foramen Ovale ◽

Septal Defect ◽

Foramen Ovale ◽

Atrial Septal Defect Closure ◽

Eustachian Valve ◽

Flow Through ◽

Antegrade Flow ◽

Chronic Hypoxemia

Prominent Eustachian valves, with obligate right-to-left shunts, have been reported as a cause of neonatal hypoxemia. This anomaly can present as an obstructive structure that inhibits antegrade flow through the tricuspid valve and furthermore contributes to right-to-left atrial shunting in the presence of a patent foramen ovale or atrial septal defect. This case highlights the evaluation and diagnostic workup for chronic hypoxemia in an adolescent female patient and considerations for percutaneous atrial septal defect closure.

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