337 Do patients with severe pulmonary hypertension profit from interventional closure of Atrial Septal Defect II (ASD II)?

2004 ◽  
Vol 3 (1) ◽  
pp. 85
Author(s):  
M RESCHKE
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Severe Pulmonary Hypertension ◽  
Interventional Closure

Surgical Strategy in Patients with Atrial Septal Defect and Severe Pulmonary Hypertension

2012 ◽  
Vol 15 (2) ◽  
pp. 111 ◽  
Author(s):  
Yang Hyun Cho ◽  
Tae-Gook Jun ◽  
Ji-Hyuk Yang ◽  
Pyo Won Park ◽  
June Huh ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Maze Procedure ◽  
Severe Pulmonary Hypertension ◽  
Tricuspid Annuloplasty ◽  
Pulmonary Arterial ◽  
Asd Closure

The aim of the study was to review our experience with atrial septal defect (ASD) closure with a fenestrated patch in patients with severe pulmonary hypertension. Between July 2004 and February 2009, 16 patients with isolated ASD underwent closure with a fenestrated patch. All patients had a secundum type ASD and severe pulmonary hypertension. Patients ranged in age from 6 to 57 years (mean � SD, 34.9 � 13.5 years). The follow-up period was 9 to 59 months (mean, 34.5 � 13.1 months). The ranges of preoperative systolic and pulmonary arterial pressures were 63 to 119 mm Hg (mean, 83.8 � 13.9 mm Hg) and 37 to 77 mm Hg (mean, 51.1 � 10.1 mm Hg). The ranges of preoperative values for the ratio of the pulmonary flow to the systemic flow and for pulmonary arterial resistance were 1.1 to 2.7 (mean, 1.95 � 0.5) and 3.9 to 16.7 Wood units (mean, 9.8 � 2.9 Wood units), respectively. There was no early or late mortality. Tricuspid annuloplasty was performed in 14 patients (87.5%). The peak tricuspid regurgitation gradient and the ratio of the systolic pulmonary artery pressure to the systemic arterial pressure were decreased in all patients. The New York Heart Association class and the grade of tricuspid regurgitation were improved in 13 patients (81.2%) and 15 patients (93.7%), respectively. ASD closure in patients with severe pulmonary hypertension can be performed safely if we create fenestration. Tricuspid annuloplasty and a Cox maze procedure may improve the clinical result. Close observation and follow-up will be needed to validate the long-term benefits.

scholarly journals ATRIAL SEPTAL DEFECT- INDUCED PARTIALLY REVERSIBLE SEVERE PULMONARY HYPERTENSION: WHAT SHOULD WE DO?

2016 ◽  
Vol 67 (13) ◽  
pp. 1097
Author(s):  
Mugurel Valentin Bazavan ◽  
Abdalla Hassan ◽  
Maria Bazavan ◽  
Susheela Hadigal ◽  
Sorin Danciu
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Severe Pulmonary Hypertension

Abstract 2130: Long-term Outcomes of Adult Atrial Septal Defect With Severe Pulmonary Hypertension After Surgical Closure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jeong-Hoon Kim ◽  
Duk-Hyun Kang ◽  
Jong-Young Lee ◽  
Jong-Min Song ◽  
Tae-Jin Yun ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Survival Rates ◽  
Severe Pulmonary Hypertension ◽  
Term Survival ◽  
Surgical Closure

The benefits of surgical closure has been unclear in adult atrial septal defect (ASD) with severe pulmonary hypertension (PHT), and we tried to evaluate improvement of PHT and long-term survival after surgical closure compared to medical follow-up. Methods: From 1996 to 2006, we included a total of 71 adult ASD patients (age; 43±15 years) with severe PHT documented by echocardiography. The inclusion criteria were defined as ASD diameter > 15 mm, enlarged right ventricle, and the baseline peak velocity of tricuspid regurgitation (TR) ≥ 4.0 m/sec. We excluded 5 patients with Eisenmenger syndrome documented by cardiac catheterization. Surgical closure was performed on 55 patients (OP group) and the remaining 16 patients were followed up medically (MED group). The improvement of PHT was defined as TR velocity ≤ 3.5 m/sec on follow-up echo. Results: Baseline characteristics and clinical results were compared between the two groups in table . There were no significant differences in terms of gender, ASD diameter, cardiac rhythm, and TR velocity, but the MED group was significantly older. During follow-up of 46±33 months, there were 5 deaths in the MED group and no operative or late death in the OP group, and the 5-year actuarial survival rate of the OP group was significantly higher than the MED group (58±15%, p<0.05). On subgroup analysis according to age, the OP group showed significantly better survival rates than the MED group (p<0.05) in elderly patients (age > 50). In the OP group, TR velocity was significantly decreased from 4.5±0.4 to 3.0±0.7 m/sec on follow-up echo, and improvement of PHT was observed in 47 (85%) patients. On multivariate analysis, female gender and lower baseline TR velocity were the significant independent predictors of improved PHT after surgery. Conclusions: In adult ASD with severe PHT, surgical closure can be safely performed and improve PHT effectively. Especially in elderly patients, ASD closure is significantly related with the better survival rates.

Echocardiographic correlates of severe pulmonary hypertension in adult patients with ostium secundum atrial septal defect

2016 ◽  
Vol 33 (12) ◽  
pp. 1891-1896 ◽  
Author(s):  
Jorge Cossío-Aranda ◽  
Karina Del Valle Zamora ◽  
Navin C. Nanda ◽  
Anezi Uzendu ◽  
Candace Keirns ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Adult Patients ◽  
Severe Pulmonary Hypertension ◽  
Secundum Atrial Septal Defect

scholarly journals Atrial Septal Defect dengan Hipertensi Pulmonal Berat yang Dijadwalkan untuk Seksio Sesarea

2020 ◽  
Vol 1 (1) ◽  
pp. 33-9
Author(s):  
Muhammad Rodli ◽  
Isngadi Isngadi
Keyword(s):  
Blood Pressure ◽  
Pulmonary Hypertension ◽  
Cesarean Section ◽  
Atrial Septal Defect ◽  
Epidural Anesthesia ◽  
Congenital Heart ◽  
Septal Defect ◽  
Severe Pulmonary Hypertension ◽  
Central Venous ◽  
Congenital Diseases

Kelainan jantung kongenital dan sistem kardiovaskular terjadi pada 7 sampai 10 per 1.000 kelahiran hidup (0,7%–1,0%). Penyakit jantung kongenital adalah bentuk penyakit bawaan yang paling umum dan sekitar 30% dari semua kejadian penyakit bawaan. Cacat jantung kongenital yang paling sering terabaikan pada masa kanak-kanak adalah Atrial Septal Defect (ASD) sekundum. Resiko operasi non-jantung akan meningkat jika ditemukan gagal jantung, hipertensi pulmonal dan sianosis. Dilaporkan kasus primigravida berumur 33 tahun, dengan usia kehamilan 32–34 minggu yang menjalani seksio sesarea. Pada pemeriksaan fisik didapatkan nadi 100 x/menit (reguler), tekanan darah 115/74 mmHg, saturasi oksigen 90-94% dengan suplemen oksigen 10 L/menit, edema pada kedua tungkai, tekanan vena jugular (JVP) tidak meningkat. Hasil laboratorium dalam batas normal. Hasil echocardiografi menunjukkan adanya ASD sekundum (berdiameter 2–3 cm), bidirectional shunt dominan kanan ke kiri (sindroma Eisenmenger), regurgitasi trikuspid, hipertensi pulmonal berat dengan perkiraan tekanan sistolik ventrikel kanan 109 mmHg dan ejeksi sistolik ventrikel kiri 67%. Teknik anestesi yang digunakan adalah anestesi epidural. Dilakukan pemasangan kateter vena sentral untuk memantau tekanan vena sentral. Regimen epidural yang digunakan adalah bupivacaine plain 0,3% dan fentanyl 50 mcg total volume 15 ml dengan teknik titrasi. Selama seksio sesarea, tekanan darah stabil, detak jantung dan saturasi oksigen baik. Pasien dipantau di ruang pemulihan selama 1 jam dan kemudian dipindahkan ke ICU dan dipulangkan pada hari ke 10 pasca operasi. Kesimpulan, pasien dengan ASD dan hipertensi pulmonal yang menjalani seksio sesarea dapat dilakukan anestesi epidural dengan teknik titrasi.   Atrial Septal Defect with Severe Pulmonary Hypertension was Scheduled for Cesarean Section Abstract Congenital abnormalities of the heart and cardiovascular system occur in 7 to 10 per 1,000 of live births (0.7 - 1.0%). Congenital heart disease is the most common form of congenital diseases and amounted to approximately 30% of all incidents of congenital diseases. Congenital heart defects are most often neglected in childhood is secundum atrial septal defect (ASD). The risk for non-cardiac surgery would increase if found heart failure, pulmonary hypertension and cyanosis. A 33-years old primigravida, in labor at 32-34 weeks of gestation who underwent caesarean section under epidural anesthesia. On physical examination pulse was 100 x/min, blood pressure was 115/74 mmHg, oxygen saturation was 90-94% with oxygen supplement 10 L/min, bilateral pitting pedal edema was present. All the laboratory results within normal limits. 2D Echo results osteum secundum ASD (2-3 cm in diameter), bidirectional shunt dominan right to left shunt (Eisenmenger’s syndrome), Tricuspid Regurgitation, Severe Pulmonary Hypertension with an estimated right ventricle systolic pressure of 109 mmHg and left ventricle systolic ejection fraction of 67%. The anesthetic technique was epidural anesthesia. We performed central venous catheter to monitoring central venous pressure. The epidural regimens used were bupivacaine plain 0,3% and fentanyl 50 mcg total volume 15 ml with titration techniques. During cesarean section, patient was stable blood pressure, heart rate and oxygen saturation. Patient was monitored in recovery room for 1 hour and then transferred to ICU and discharged on 10th postoperative day. Conclusion, patients with ASD and severe pulmonary hipertention, we can perform epidural anesthesia with titration techniques.

scholarly journals Closure of secundum atrial septal defect with a fenestrated occluder in a patient with severe pulmonary hypertension

2021 ◽  
Author(s):  
Sylwia Sławek-Szmyt ◽  
Aleksander Araszkiewicz ◽  
Olga Trojnarska ◽  
Agata Markiewicz ◽  
Stanisław Jankiewicz ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Severe Pulmonary Hypertension ◽  
Secundum Atrial Septal Defect
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