Transhepatic device closure of large atrial septal defect

2021 ◽  
pp. 1-3
Author(s):  
Ata Firouzi ◽  
Sedigheh Saedi ◽  
Tahereh Saedi
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Venous Access ◽  
Alternative Methods ◽  
Caval Vein ◽  
Transfemoral Approach ◽  
Atrial Septal Defect Closure ◽  
Septal Defects ◽  
Inferior Caval Vein ◽  
Device Implantation

Abstract Transcatheter closure of secundum-type atrial septal defects has become the treatment of choice in the majority of cases. Femoral venous access is the standard rout for device implantation. Anatomic abnormalities of venous system including interrupted inferior caval vein with azygous continuation can make the percutaneous procedure more complicated. In such instances, alternative methods of transjugular or transhepatic approach or surgical repair should be considered. We present the case of a 50-year-old male with secundum-type atrial septal defect and a rare form of segmental interruption of inferior caval vein and describe successful atrial septal defect closure through transfemoral approach.

Transcatheter closure of atrial septal defect in a patient with absent inferior caval vein connection: a novel technique using a steerable guide catheter

2016 ◽  
Vol 26 (5) ◽  
pp. 1033-1035 ◽  
Author(s):  
Yoichi Takaya ◽  
Teiji Akagi ◽  
Hiroshi Ito
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Defect Closure ◽  
Caval Vein ◽  
Atrial Septal Defect Closure ◽  
Novel Technique ◽  
Inferior Caval Vein ◽  
Guide Catheter ◽  
Alternative Approach

AbstractAn alternative approach for transcatheter closure of atrial septal defect is necessary in patients with absent inferior caval vein connection. In this report, we describe the successful transcatheter atrial septal defect closure via the transjugular approach using a steerable guide catheter.

Percutaneous closure of ostium secundum atrial septal defect using left internal jugular vein access in a child with situs inversus and absence of inferior caval vein

2019 ◽  
Vol 29 (10) ◽  
pp. 1310-1312
Author(s):  
Edmundo C. Oliveira ◽  
Marco A. G. Moura ◽  
José A. Almeida ◽  
Antonio L. P. Ribeiro ◽  
Bruno R. Nascimento
Keyword(s):  
Atrial Septal Defect ◽  
Internal Jugular Vein ◽  
Situs Inversus ◽  
Septal Defect ◽  
Jugular Vein ◽  
Left Internal Jugular Vein ◽  
Caval Vein ◽  
Atrial Septal Defect Closure ◽  
Inferior Caval Vein ◽  
Vein Access

AbstractFemoral vein access is the first choice for percutaneous atrial septal defect closure, and when it cannot be used due to anatomic reasons, the alternative sites should be considered, frequently increasing the complexity of the procedure. Here we report the case of a 3-year-old boy, with situs inversus and dextrocardia, electively referred for percutaneous closure of an ostium secundum atrial septal defect. During the procedure, agenesis of the infra-hepatic segment of the inferior caval vein was diagnosed, and no double inferior caval vein or right superior caval vein were identified by ultrasound or angiography. Therefore, we opted to perform the procedure through the left internal jugular vein, with fluoroscopy and transesophageal echocardiographic guidance. Catheters were navigated through a hydrophilic guidewire, and a Stiff guidewire was positioned in the left ventricle for better support. An Amplatzer septa occluder 19 was successfully deployed without major difficulties and the patient was discharged after 24 hours in good clinical condition. Percutaneous atrial septal defect closure through alternative access sites, especially in the presence of situs inversus, may pose significant challenges to the interventional team. In this case, the left internal jugular vein has shown to be a feasible option, allowing the navigation and manipulation of devices without complications. Provided the expertise of the interventional team, and awareness of the risks involved, alternative access sites can be successfully used for paediatric structural interventions.

Hybrid closure of a large atrial septal defect using Occlutech Flex II septal occluder in a patient with interrupted inferior caval vein

2020 ◽  
Vol 30 (6) ◽  
pp. 880-882
Author(s):  
Amjad Bani Hani ◽  
Mai Abdullattif ◽  
Iyad AL-Ammouri
Keyword(s):  
Cardiopulmonary Bypass ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Inferior Caval Vein ◽  
Thoracotomy Incision

AbstractWe present a case of a 31-year-old male with a large atrial septal defect, who was found to have interrupted inferior caval vein with azygous continuation to the superior caval vein, which precluded transcutaneous closure by device. The defect was successfully closed with a 33 mm Occlutech Figula septal occluder using a sub-mammary small thoracotomy incision and per-atrial approach without using cardiopulmonary bypass. The patient was discharged home after 48 hours of procedure.

Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children

2019 ◽  
Vol 29 (5) ◽  
pp. 626-636 ◽  
Author(s):  
Gustaf Tanghöj ◽  
Petru Liuba ◽  
Gunnar Sjöberg ◽  
Annika Rydberg ◽  
Estelle Naumburg
Keyword(s):  
Adverse Events ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Survival Curve ◽  
Percutaneous Closure ◽  
Defect Closure ◽  
Atrial Septal Defect Closure ◽  
Preterm Children ◽  
Septal Defects ◽  
Atrial Septal Defects

AbstractIntroduction:Atrial septal defect is the third most common CHD. A hemodynamically significant atrial septal defect causes volume overload of the right side of the heart. Preterm children may suffer from both pulmonary and cardiac comorbidities, including altered myocardial function. The aim of this study was to compare the rate of adverse events following atrial septal defect closure in preterm- and term-born children.Method:We performed a retrospective cohort study including children born in Sweden, who had a surgical or percutaneous atrial septal defect closure at the children’s hospitals in Lund and Stockholm, between 2000 and 2014, assessing time to the first event within 1 month or 1 year. We analysed differences in the number of and the time to events between the preterm and term cohort using the Kaplan–Meier survival curve, a generalised model applying zero-inflated Poisson distribution and Gary-Anderson’s method.Results:Overall, 413 children were included in the study. Of these, 93 (22.5%) were born prematurely. The total number of adverse events was 178 (110 minor and 68 major). There was no difference between the cohorts in the number of events, whether within 1 month or within a year, between major (p = 0.69) and minor (p = 0.84) events or frequencies of multiple events (p = 0.92).Conclusion:Despite earlier procedural age, larger atrial septal defects, and higher comorbidity than term children, preterm children appear to have comparable risk for complications during the first year after surgical or percutaneous closure.

Transhepatic atrial septal defect closure: simple way to achieve haemostasis in a patient with important co-morbidities

2020 ◽  
Vol 30 (9) ◽  
pp. 1343-1345
Author(s):  
Raymond N. Haddad ◽  
Geert Maleux ◽  
Damien Bonnet ◽  
Sophie Malekzadeh-Milani
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Standard Treatment ◽  
Interatrial Septum ◽  
Gelatin Sponge ◽  
Attractive Alternative ◽  
Defect Closure ◽  
Atrial Septal Defect Closure ◽  
Septal Defects ◽  
Vascular Sheath

AbstractPercutaneous closure is the gold standard treatment for atrial septal defects, but the procedure can be complex in case of femoral thrombosis. Although unusual for congenital interventionists, transhepatic atrial septal defect closure is an attractive alternative to the internal jugular vein, especially when approaching the interatrial septum. Herein, we report the case of an adult patient with significant co-morbidities who had successful transhepatic atrial septal defect closure after a failed transjugular attempt. We describe the use of an absorbable haemostatic gelatin sponge to efficiently and safely achieve haemostasis after the use of a large vascular sheath with combined anticoagulation and antiplatelet therapy.

Effects of reducing frame rate from 7.5 to 4 frames per second on radiation exposure in transcatheter atrial septal defect closure

2018 ◽  
Vol 28 (11) ◽  
pp. 1323-1328 ◽  
Author(s):  
Younes Boudjemline
Keyword(s):  
Atrial Septal Defect ◽  
Radiation Exposure ◽  
Septal Defect ◽  
Frame Rate ◽  
Atrial Septal Defect Closure ◽  
Dose Area Product ◽  
Air Kerma ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Area Product

AbstractObjectivesThe aim of this study was to evaluate the reduction of frame rate from 7.5 to 4 frames per second on radiation exposure and to provide new standards of radiation exposure.BackgroundFrame rate is a large contributor to radiation exposure. The use of 4 frames per second for closure of atrial septal defects has been reported not to affect the level of radiation exposure.MethodsWe retrospectively reviewed radiation data from all patients referred to our catheterisation laboratory for closure of an atrial septal defect between January, 2015 and June, 2017. Fluoroscopic time, dose area product (μGy.m2), and total air kerma (mGy) were collected. These values were compared according to the frame rate used for closure of atrial septal defects.ResultsA total of 49 atrial septal defects were closed using 7.5 frames per second and 85 using 4 frames per second. Baseline characteristics were similar in both groups. Procedural success was similar in both groups (100 versus 98.8%). Median total air kerma and dose area product were statistically lower in the 4 frames per second group (4 versus 1.3 mGy [p=0.00012]), 43.7 versus 13.1 μGy.m2 [p<0.00001]). There was no increase in median procedure and fluoroscopic times (respectively, 10 and 1.1 min for 7.5 and 4 frames per second), or complications (4.1 versus 2.3%, p>0.05).ConclusionReduction of frame rate allows reducing significantly the radiation exposure while maintaining excellent clinical results in transcatheter closure of atrial septal defects. We recommend implementing this little change in every laboratory in order to achieve drastic reduction of radiation exposure to the patients and laboratory personnel.

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