Feasibility, Safety and Long-Term Follow-Up of Transcatheter Closure of Secundum Atrial Septal Defects with Deficient Rims

Cardiology ◽  
2016 ◽  
Vol 134 (2) ◽  
pp. 118-126 ◽  
Author(s):  
Chunhui Cao ◽  
Zhonghua Wang ◽  
Jun Huang ◽  
Lingxia Fan ◽  
Ren Li ◽  
...  
Keyword(s):  
Success Rate ◽  
Transcatheter Closure ◽  
Operation Time ◽  
Residual Shunt ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Heart Arrhythmia ◽  
Long Term Follow Up

Objective: The aim of this work was to evaluate the feasibility and safety of transcatheter closure procedures for the treatment of atrial septal defects (ASDs) with insufficient rims. Methods: A total of 507 secondary ASDs were divided into two groups based on whether they had deficient rims or not (152 vs. 355 cases, respectively). Any complications, including residual shunt, heart arrhythmia, occluder translocation, etc., were followed up for 1-3 years. Results: There were no differences in gender, weight, exposure time, ECG states, pulmonary pressure, the intervention success rate, occurrence of residual shunt, the operation time and occurrence of residual shunt during follow-up between the two groups (p > 0.05). However, the occurrence of rhythm disorders was significantly different between the two groups; ASDs with deficient rims were at an elevated risk (p < 0.05). Specifically, there was a significantly higher incidence in the occurrence of arrhythmia in the deficient rims group at 24 h postoperation, but no differences in arrhythmia incidence at any of the other follow-up time points (1, 3, 6, 12 and 36 months; p > 0.05). Conclusions: Patients with deficient rims experience a high success rate of ASD intervention and low rate of complications when the procedures are performed by experienced operators.

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.

scholarly journals Transcatheter closure of very large secundum atrial septal defects: long-term follow-up study

Heart ◽  
2011 ◽  
Vol 97 (Suppl 3) ◽  
pp. A205-A206
Author(s):  
W. Hong ◽  
L. Jing ◽  
Z. Xianxian ◽  
L. Bo ◽  
W. Yanyan ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Follow Up Study ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Long Term Follow Up

scholarly journals Individualized Experience With Percutaneous Transcatheter Closure of Multiple Atrial Septal Defects: A Single-Center Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhenquan Wang ◽  
Yi Zhan ◽  
Jiahui Jin ◽  
Tingting Wu ◽  
Songyue Zhang ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Atrial Septal Aneurysm ◽  
Single Center ◽  
Residual Shunt ◽  
Closure Rate ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Single Center Study ◽  
Center Study

Multiple atrial septal defects (ASDs) are one type of secundum ASD, most of which have an atrial septal aneurysm or long interdefect distance. In our retrospective single-center study, we reviewed different closure strategies for multiple ASDs. We analyzed 50 patients who underwent percutaneous transcatheter closure from May 2011 to July 2019. Information on the patients' characteristics, operation procedure, occluder selection, and complications was collected. According to the feature of the defects and device choice, multiple ASDs were divided into five groups. A successful operation was achieved in every patient. A total of 50 patients were implanted with 58 devices, with 26 patients implanted with a single standard ASD occluder (ASDO); six patients were implanted with double standard ASDOs, and only one patient was implanted with three standard ASDOs. There were 17 patients whose closure was made using the small-waist–big-edge ASDO. Seventy-six percent of the patients (38/50) had an immediate residual shunt. During the mean follow-up of 25.76 ± 22.53 months, the complete closure rate was 92%. Except for two patients with a transient atrioventricular block, individualized experience with percutaneous transcatheter closure for multiple ASDs was effective in a single-center study. After a mid- to long-term follow-up, the multiple ASDOs and small-waist–big-edge ASDO had no serious adverse events or complications.

Transcatheter closure of various types of defects within the oval fossa using the double umbrella device (CardioSEAL) – feasibility and echocardiographic follow-up

2001 ◽  
Vol 11 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Renate Kaulitz ◽  
Matthias Peuster ◽  
Christian Jux ◽  
Thomas Paul ◽  
Gerd Hausdorf
Keyword(s):  
Transcatheter Closure ◽  
Right Atrial ◽  
Medium Term ◽  
Morphological Variations ◽  
Septal Defects ◽  
Long Term Follow Up ◽  
The Right ◽  
Echocardiographic Findings

Data on long-term follow-up for closure of so-called secundum type“ atrial septal defects within the oval fossa using recently developed devices are limited, and results focused on presence of residual shunting. The purpose of our study was to report the experience from a single center establishing the effectiveness of transcatheter closure in patients with various types of defect other than those located centrally within the oval fossa.A total of 72 patients was included in this study. On transesophageal echocardiography, the size of the defects varied from 6 to 18 mm, with estimation of the stretched diameter from 11 to 21 mm. The ratio of stretched diameter to the extent of the residual septum ranged from 0.28 to 0.54. Mean follow-up was 30.5+ 7.4 months, with a range from 13 to 42 months. The rate of closure using devices with diameters from 28 to 40 mm increased from 80% immediately after implantation to 93% in the 57 patients examined 24 months after implantation. For further analysis, we compared the 44 patients with a solitary, centrally located, defect to 28 having morphological variations, including superiorly located defects with deficient superior and aortic rims, multifenestrated and aneurysmal defects, or isolated additional defects. There was no incidence of formation of thrombus, sustained atrial arrhythmia, or infective endocarditis. Residual shunting was not influenced by location or morphology of the defects, but increased with size, stretched diameter, and the ratio of pulmonary to systemic flows. Serial transthoracic echocardiographic findings revealed malposition of one right-sided superior arm of the device in 8 patients, while protrusion of one leftsided arm onto the right atrial aspect was observed in 3 patients. Fluoroscopy showed fatigue fracture of a single arm in 7 patients (9.7%) within the first 6 months after implantation.These results demonstrate that transcatheter closure with the non self-centering double umbrella device was effective and safe on medium-term follow-up, and could be extended to defects within the oval fossa having various morphologies. Residual shunting resolved with time, and was not related to either morphology or the position of the device.

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.

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