Comparative Changes of Pulmonary Artery Pressure Values and Tricuspid Valve Regurgitation Following Transcatheter Atrial Septal Defect Closure in Adults and the Elderly

Totally endoscopic robotic surgery is a safe approach to atrial septal defect closure in adults. Robotic approach can be an alternative to traditional incisions in the management of concomitant tricuspid valve regurgitation with ruptured chordae tendineae. Herein, we describe a woman who presented with atrial septal defect and tricuspid insufficiency after an unsuccessful percutaneous intervention with device removal from the right ventricle. Concomitant closure of septal defect and tricuspid valve repair with artificial chords was successfully performed using robot assistance.

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Atrial Septal Defects in the Elderly: A Study of Clinical and Echocardiographic Predictors of Atrial Septal Defect Closure

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2013.07.108 ◽

2013 ◽

Vol 29 (10) ◽

pp. S92

Author(s):

A. Yeung ◽

J. Jue

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

The Elderly ◽

Defect Closure ◽

Atrial Septal Defect Closure ◽

Septal Defects ◽

Atrial Septal Defects

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Predictive Model for Secundum Atrial Septal Defect Closure with Pulmonary Artery Hypertension in Adult: When to Close

The Heart Surgery Forum ◽

10.1532/hsf.1914 ◽

2018 ◽

Vol 21 (2) ◽

pp. 108

Author(s):

Supomo Supomo ◽

Adika Zhulhi Arjana ◽

Handy Darmawan

Keyword(s):

Pulmonary Artery ◽

Atrial Septal Defect ◽

Predictive Model ◽

Multiple Regression ◽

Septal Defect ◽

Pulmonary Artery Hypertension ◽

Defect Closure ◽

Secundum Atrial Septal Defect ◽

Atrial Septal Defect Closure ◽

Significant Difference

Background: Secundum atrial septal defect (SASD) closure is contraindicated in the presence of severe pulmonary artery hypertension (PAH). However, there is no consensus on the threshold of severe PAH, in terms of mean pulmonary artery pressure (mPAP), which would contraindicate for defect closure surgery in adults. Furthermore, PAH can persist, or even increase in severity, after the closure. The aim of this study was to produce a predictive model correlating mPAP in adult SASD patients with PAH after defect closure surgery. Methods: Between January 2014 and March 2017, 29 consecutive adult SASD patients who had PAH and underwent defect closure surgery were included in the study. Age, right atrium (RA) dimension, right ventricle (RV) dimension, and mPAP before surgery were analyzed using multiple regression to produce the model.Results: Multiple regression produced the following model: mPAP prediction = (0.24)(Age) + (0.06)(mPAP before surgery) + (0.17)(RA dimension) + (0.47)(RV dimension) – 13.79 (P = .0008). The mPAP prediction was compared to mPAP of the patients six to nine months after surgery, and showed no significant difference (P = .9562). Conclusion: In adult SASD patients with PAH, our model can significantly predict the mPAP after the closure. If the predicted mPAP is within its normal range, the closure is indicated.

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