Persistent electrical and morphological atrial abnormalities after early closure of atrial septal defect

2004 ◽  
Vol 14 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Clifford L. Cua ◽  
Elizabeth E. Sparks ◽  
David P. Chan ◽  
Curt J. Daniels
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Pearson Correlation ◽  
P Wave ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Pr Interval ◽  
Early Closure ◽  
The Right

Atrial arrhythmias are associated with enlarged atrial chambers and an increased duration of the P wave. Repair of atrial defects within the oval fossa is expected to normalize atrial size. Few studies, however, have evaluated electrical and morphological atrial features after repair. Our study was performed to determine if atrial abnormalities exist after surgical closure of such atrial septal defects, and whether early closure improves outcome. We recruited patients who had undergone surgical closure of a defect within the oval fossa, so-called “secundum” atrial septal defects. Electrocardiograms, signal averaged electrocardiograms, and echocardiograms were performed. Two-tailed test and Pearson correlation was utilized for statistical analysis. The population consisted of 20 patients and 27 controls, with the mean age of the patient being 11.25 ± 5.10 years, their age at surgery 6.55 ± 5.10 years, and the time since surgery 4.70 ± 2.61 years. The size of the right (23.88 ± 6.35 ml/m2 versus 18.84 ± 4.43 ml/m2) and left (21.91 ± 12.47 ml/m2 versus 17.72 ± 4.83 ml/m2) atrium were significantly larger in the patients. The duration of the P wave (108 ± 16 ms versus 96 ± 8 ms) and the duration of the PR interval (155 ± 18 ms versus 138 ± 23 ms) were longer. No correlation existed between age or interval since surgery with atrial sizes or measurements of the signal averaged electrocardiogram. We conclude that, despite surgical repair, abnormalities exist in patients with an atrial septal defect. Early surgery does not appear to prevent the atrial abnormalities.

Comparative effects of surgical and percutaneous repair on P-wave and atrioventricular conduction in patients with atrial septal defect – ostium secundum type

2012 ◽  
Vol 23 (1) ◽  
pp. 132-137
Author(s):  
Hassan Javadzadegan ◽  
Mehrnoush Toufan ◽  
Ali Reza Sadighi ◽  
Joyce M. Chang ◽  
Nader D. Nader
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
P Wave ◽  
P Value ◽  
Device Closure ◽  
Wave Duration ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
P Wave Duration ◽  
Pr Interval

AbstractBoth surgical and percutaneous closures of atrial septal defects have been successful in reversal of atrial dilatation. We compared the effects of surgical and percutaneous transvenous device closure of atrial septal defect on post-operative changes of P-wave duration, PR segment, and PR interval. Electrocardiographic data were prospectively collected from 30 patients following either surgical (n equal to 16) or percutaneous (n equal to 16) repair of atrial septal defects between 2004 and 2010. A cardiologist blinded to the closure technique performed the electrocardiographic analyses. P-wave duration (98.5 plus or minus 15.4 to 86.4 plus or minus 13.2 milliseconds, p-value less than 0.05) and PR interval (162.9 plus or minus 18.5 to 140.6 plus or minus 15.2 milliseconds, p-value less than 0.05) were reduced after percutaneous transvenous device closure. P-wave duration (104.5 plus or minus 24.7 versus 83.2 plus or minus 13.3 milliseconds, p-value less than 0.05) and PR interval (173.2 plus or minus 38.7 versus 144.3 plus or minus 32.0 milliseconds, p-value less than 0.05) were also reduced after surgical closure. PR segment in the percutaneous group was significantly reduced (63.4 plus or minus 14.5 to 52.1 plus or minus 10.8 milliseconds, p-value less than 0.05), but not in the surgical group (68.6 plus or minus 18.7 versus 61.1 plus or minus 24.7 milliseconds). However, the difference in PR segment changes between the two groups was not significant (−11.3 plus or minus 15.0 versus −7.6 plus or minus 20.5 milliseconds, p-value equal to 0.18). Our analysis demonstrates that the changes between the two groups were not different and that both closure techniques reduce P-wave duration, PR segment, and PR interval within 6 months.

P-wave dispersion between transcatheter and surgical closure of secundum-type atrial septal defect in childhood

2010 ◽  
Vol 21 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Osman Baspinar ◽  
Murat Sucu ◽  
Senem Koruk ◽  
Mehmet Kervancioglu ◽  
Hasim Ustunsoy ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Wave Dispersion ◽  
P Wave ◽  
Amplatzer Septal Occluder ◽  
P Wave Dispersion ◽  
Surgical Closure ◽  
Septal Defects ◽  
The Mean

AbstractPatients with atrial septal defect have an increased risk for atrial fibrillation. Increased P-wave dispersion predicts the development of atrial fibrillation. The aim of this study was to determine difference in P dispersion between transcatheter closure with Amplatzer septal occluder and surgical closure in childhood. A total of 68 children (the mean age was 7.2 plus or minus 3.3 years; the mean secundum atrial septal defects diameter was 17.3 plus or minus 5.4 millimetres) were evaluated in this study. Transcatheter closure was attempted in 41 children with secundum atrial septal defects, and the defect in 27 patients was closed by surgical techniques. P maximum, P minimum and P dispersion were measured by the 12-lead surface electrocardiography. P maximum, P minimum and P dispersion were found to be similar in patients with pre- and post-procedure (98.0 plus or minus 19.3 versus 95.1 plus or minus 23.0 milliseconds; 68.0 plus or minus 20.8 versus 67.6 plus or minus 24.3 milliseconds, 29.9 plus or minus 11.0 versus 27.1 plus or minus 12.1 milliseconds, respectively). There was no statistical significance in the comparison of P dispersion between the two groups. But in the surgical group, P-wave dispersion was decreased more significantly compared with baseline values (p-value equal to 0.03). In conclusion, there is no P dispersion between transcatheter closure with Amplatzer septal occluder and surgical closure of secundum atrial septal defect.

Atrial septal defect

ESC CardioMed ◽  
2018 ◽  
pp. 790-793
Author(s):  
Robert Yates ◽  
Marc Gewillig
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Atrial Arrhythmias ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Long Term Follow Up ◽  
Early Closure ◽  
Symptomatic Benefit

Secundum atrial septal defects are usually well tolerated in childhood but may cause significant symptoms in adults. Early closure is therefore recommended and can be achieved by catheter in the majority. Symptomatic benefit is noted at any age, but long-term follow-up is required as closure in adulthood does not prevent atrial arrhythmias.

Infective endocarditis on an occluder closing an atrial septal defect

1999 ◽  
Vol 9 (1) ◽  
pp. 65-67 ◽  
Author(s):  
A. M. Bullock ◽  
S. Menahem ◽  
J. L. Wilkinson
Keyword(s):  
Infective Endocarditis ◽  
Atrial Septal Defect ◽  
Antibiotic Prophylaxis ◽  
Potential Risk ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
First Case

AbstractClosure of atrial septal defects be means of intravenous catheterisation has been undertaken using a variety of devices as an alternative to surgical closure.1–5 We describe the first case, to the best of our knowledge, of infective endocarditis complicating a successful transcatheter closure. This highlights the potential risk of this procedure, and emphasises the need for appropriate antibiotic prophylaxis until complete endothelialization of the device has occurred.

scholarly journals Outcome of Surgical Closure of Atrial Septal Defect in Sulaimani City

2020 ◽  
Author(s):  
Aso Faeq Salih ◽  
Hakam Marwan Mhadi ◽  
Shkar Raeof
Keyword(s):  
Atrial Septal Defect ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Age Group ◽  
Open Heart ◽  
Group 13 ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

An atrial septal defect (ASD), sometimes called a hole in the heart is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). To determine the outcome of surgical closure in patients with atrial septal defects, we designed a retrospective study, including 120 patients present with an atrial septal defect after surgical closure done in the cardiac teaching center in Sulaimani city. The data collected include the patients that admitted which are known cases of ASD and treated by open heart surgery during the last nine years from 1st of January 2008 until the 1st of January 2018. A total of 120 children diagnosed with Atrial Septal Defect (ASD) were included in this study with a mean age of 7.8±4.4 years; 32.5% of them were 1-5 years old, 50.8% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. Only three ASD children received medical treatment while all of them were treated surgically with open-heart surgery. The mean age of ASD children at surgery was7.8±4.4 years; 5.8% of them were 1-2 years old, 28.4% of them were 3-5 years old, 49.1% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. There was a significant association between primum ASD type and large ASD with posteroinferior deficient rims (P=0.04). A significant association was observed between primum ASD type and large IAS (P=0.006). Mean ASD diameter was significantly higher among patients with primum ASD type (P=0.01). The outcome of surgical closure of the atrial septal defect in children is effective and safe. Ventricular arrhythmia in the form of ectopic was the postoperative complication in one patient. The main echocardiography findings of children with atrial septal defects were large ASD with posteroinferior deficient rims.

scholarly journals Changes of Cardiac Rhythm after Closure of Secundum Atrial Septal Defect in Children

2020 ◽  
pp. 84-96
Author(s):  
Esraa A. Sorour ◽  
Elatafy E. Elatafy ◽  
Wael N. Lotfy ◽  
Amr M. Zoair
Keyword(s):  
Risk Factors ◽  
Atrial Septal Defect ◽  
Pediatric Patients ◽  
Septal Defect ◽  
Hemodynamic Instability ◽  
Right Atrial ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

Background: Arrhythmias may complicate congenital heart diseases, such as secundum atrial septal defects. We aimed at following up the rhythm changes in children after closure of ostiumsecundum atrial septal defects. Methods: The current study was conducted in the Pediatric Cardiology Unit, Tanta University, on 60 pediatric patients who had undergone either trans-catheter or surgical closure of secundum atrial septal defects. Complete history taking and full clinical assessment were done. Echocardiographic assessment was performed to detect any residual defects, and assess chamber dimensions, and cardiac functions. Electrocardiographic assessment including Holter monitoring was performed within two months after the procedure, after six months, and after one year. Arrhythmias were classified into major and minor types. All results were statistically analyzed and tabulated. Results: There were no significant differences between the pre-closure rhythm and the rhythm after closure of the defects throughout the follow-up. The percentage of patients with major arrhythmias has increased from 6.7% of the total sample to 13.3%, 11.6%, and 11.6% in the early, midterm and late follow up respectively. The significant risk factors for postoperative arrhythmias were; pre-closure arrhythmia, right atrial dilatation, and serious hemodynamic instability in the early follow up. Conclusions: We concluded that arrhythmias were common before and after atrial septal defect closure, without significant differences. Pre-closure arrhythmia, right atrial dilatation, and serious hemodynamic instability are considered important risk factors of arrhythmias after secundum atrial septal defect’s closure in pediatric patients.

scholarly journals The role of three-dimensional transesophageal echocardiography in preoperative assessment of atrial septal defects

2015 ◽  
Vol 18 (1) ◽  
pp. 58 ◽  
Author(s):  
D. G. Tarasov ◽  
I. V. Tkachev ◽  
S. S. Kadrabulatova
Keyword(s):  
Atrial Septal Defect ◽  
Transesophageal Echocardiography ◽  
Septal Defect ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Maximum Diameter ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

An atrial septal defect is the most common congenital heart disease. Transcatheter defect closure has become widespread in recent times and the requirements for this procedure are rather strict. Two-dimensional echocardiography is limited in evaluating atrial septal defects because it provides planar images only. In order to preoperatively assess atrial septal defects, we applied three-dimensional transesophageal echocardiography and then compared the results with those of surgical operations. The maximum diameter, shape, area and localization of the atrial septal defect in 26 patients were estimated with three-dimensional echocardiography. It was found out that positive correlation existed between three-dimensional echocardiography findings and those measured during surgery. Three-dimensional echocardiography provides invaluable assistance in preoperative evaluation of atrial septal defects and in selection of treatment.

Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder

1999 ◽  
Vol 9 (5) ◽  
pp. 468-473 ◽  
Author(s):  
Felix Berger ◽  
Peter Ewert ◽  
Per G. Boöjrnstad ◽  
Ingo Dähnert ◽  
Gregor Krings ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Paradoxical Embolism ◽  
Residual Shunt ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Diagnostic Cardiac Catheterization ◽  
Long Term Follow Up

AbstractTo judge whether an Amplatzer™ Septal Occluder can be used as standard therapy instead of surgery for closure of atrial septal defects we report our experiences in 200 patients. Of these patients, 127 had an atrial septal defect with haemodynamically significant left-to-right shunt, 68 patients a persistent oval foramen after presumed paradoxical embolism, and 5 had a fenestration after Fontan-repair. Mean age was 29.8 years (0.8 to 77.7 years). Body weight ranged from 6.9 to 120.0 kg (mean 51.5 kg). After diagnostic cardiac catheterization, and balloon-sizing of the defect, we implanted Amplatzer™ Septal Occluders with stents of 4 to 28 mm diameter. Follow-up studies were obtained after 48hours, and one, six, and twelve months. Transcatheter closure of the atrial septal defect proved successful in all without any relevant residual shunts. In particular, complete closure was achieved in all patients after presumed paradoxical embolism. The mean period of follow-up is 9–5 months, with a range from 0.4 to 23.5 months, giving a total of 1898 patient months. The occlusion rate after three month was 98.1°. A trivial haemodynamically insignificant residual shunt remained in 1.9° of the patients. Fluoroscopy times ranged from 0 to 43.5 minutes, with a median of 8.7 minutes. The excellent results in the short and medium term in children and adults have resulted in using this device routinely at the present time for closure of central atrial septal defects up to a diameter of 28 mm. Final judgement, however, is only possible after long-term follow-up.

Pacemaker and conduction disturbances in patients with atrial septal defect

2020 ◽  
Vol 30 (7) ◽  
pp. 980-985 ◽  
Author(s):  
Diana H. R. Albæk ◽  
Sebastian Udholm ◽  
Anne-Sif L. Ovesen ◽  
Zarmiga Karunanithi ◽  
Camilla Nyboe ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Atrioventricular Block ◽  
Right Bundle Branch Block ◽  
Septal Defect ◽  
Pacemaker Implantation ◽  
Bundle Branch Block ◽  
Conduction Disturbances ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Background Population

AbstractObjective:To determine the prevalence of pacemaker and conduction disturbances in patients with atrial septal defects.Design:All patients with an atrial septal defect born before 1994 were identified in the Danish National Patient Registry, and 297 patients were analysed for atrioventricular block, bradycardia, right bundle branch block, left anterior fascicular block, left posterior fascicular block, pacemaker, and mortality. Our results were compared with pre-existing data from a healthy background population. Further, outcomes were compared between patients with open atrial septal defects and atrial septal defects closed by surgery or transcatheter.Results:Most frequent findings were incomplete right bundle branch block (40.1%), left anterior fascicular block (3.7%), atrioventricular block (3.7%), and pacemaker (3.7%). Average age at pacemaker implantation was 32 years. Patients with defects closed surgically or by transcatheter had an increased prevalence of atrioventricular block (p < 0.01), incomplete right bundle branch block (p < 0.01), and left anterior fascicular block (p = 0.02) when compared to patients with unclosed atrial septal defects. At age above 25 years, there was a considerably higher prevalence of atrioventricular block (9.4% versus 0.1%) and complete right bundle branch block (1.9% versus 0.4%) when compared to the background cohorts.Conclusions:Patients with atrial septal defects have a considerably higher prevalence of conduction abnormalities when compared to the background population. Patients with surgically or transcatheter closed atrial septal defects demonstrated a higher demand for pacemaker and a higher prevalence of atrioventricular block, incomplete right bundle branch block, and left anterior fascicular block when compared to patients with unclosed atrial septal defects.

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