Migraine attacks after transcatheter closure of atrial septal defect

Cephalalgia ◽  
2013 ◽  
Vol 33 (15) ◽  
pp. 1229-1237 ◽  
Author(s):  
Yuji Kato ◽  
Toshiki Kobayashi ◽  
Hirotaka Ishido ◽  
Takeshi Hayashi ◽  
Daisuke Furuya ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
De Novo ◽  
International Headache Society ◽  
Device Implantation ◽  
Amplatzer Device ◽  
Asd Closure ◽  
Structured Questionnaire ◽  
New Onset

Objective The purpose of our study was to evaluate the effect of atrial septal defect (ASD) closure on migraine headache attacks (MHA). Methods A total of 247 patients who underwent percutaneous ASD closure at our facilities were sent a structured questionnaire. We diagnosed MHA according to the criteria of the International Headache Society. Results A total of 207 patients were included in the study. New-onset MHA occurred in 23 patients and persisted in 15 at a mean follow-up of 45 months. Of the 29 patients who had MHA prior to ASD closure, 11 reported exacerbation of MHA, 11 reported no change and seven reported improvement within three months after ASD closure. Compared with the patients who had no MHA, patients with de novo MHA were younger and patients with MHA improvement tended to be older. Switching from aspirin to ticlopidine or clopidogrel rapidly aborted frequent MHA in nine patients who had severe symptoms after ASD closure. Conclusions These results indicate that Amplatzer device implantation can act as a permanent trigger of MHA in not a few patients, and that age may be an important predictive factor of the influence of ASD closure on MHA.

Atrial fibrillation following transcatheter atrial septal defect closure: a systematic review and meta-analysis

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319794
Author(s):  
Jonah Daniel Himelfarb ◽  
Healey Shulman ◽  
Christopher James Olesovsky ◽  
Rawan K Rumman ◽  
Laura Oliva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
De Novo ◽  
Transcatheter Closure ◽  
Meta Analysis ◽  
Congenital Cardiac Anomalies ◽  
New Onset

ObjectiveThe ostium secundum atrial septal defect (ASD) is among the most common congenital cardiac anomalies diagnosed in adulthood. A known complication of transcatheter ASD closure is the development of new-onset atrial fibrillation and flutter (AFi/AFl). These arrhythmias confer an increased risk of postoperative stroke, thrombus formation and systemic emboli. This systematic review examines the burden of de novo AFi/AFl in adults following transcatheter closure and seeks to identify risk factors for AFi/AFl development.MethodsStudies were identified by a search of MEDLINE, EMBASE and Cochrane databases from inception until 29 April 2020. A meta-analysis of AFi/AFl incidence was performed using a random-effects model.ResultsA total of 31 studies met inclusion criteria, comprising 4788 adult patients without a history of AFi/AFl. Twenty-three studies were included in quantitative synthesis and demonstrated an overall incidence rate of 1.82 patients per 100 person-years of follow-up (I2=83%). In studies that enrolled only patients ≥60 years old, the incidence was 5.21 patients per 100 person-years (I2=0%). Studies with follow-up duration ≤2 years reported an incidence of 4.05 per 100 person-years (I2=55%) compared with a rate of 1.19 per 100 person-years (I2=85%) for studies with follow-up duration >2 years.ConclusionsThe incidence of new-onset AFi/AFl is relatively low following transcatheter closure of secundum ASDs. The rate of de novo AFi/AFl, however, was significantly higher in elderly patients. Shorter follow-up time was associated with a higher reported incidence of AFi/AFl.

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 Inappropriate shocks from a transvenous implantable defibrillator caused by atrial fibrillation and a missed atrial septal defect in a patient with a modified Bentall procedure

2021 ◽  
Author(s):  
Anna Kostopoulou ◽  
Epameinontas Fountas ◽  
Olga Karapanagiotou ◽  
Stamatis Kyrzopoulos
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Implantable Defibrillator ◽  
Surgical Closure ◽  
Inappropriate Shocks ◽  
Bentall Procedure ◽  
Complication Risk ◽  
Amplatzer Device

Abstract Background Inappropriate shocks have been reported in approximately 1/3 of patients with implantable cardiac defibrillators (ICDs). We report an unusual case of inappropriate ICD shocks due to atrial fibrillation (AF) caused by a missed atrial septal defect (ASD) in a patient with a modified Bentall procedure. Case summary A 67-year-old Caucasian male, with an ICD and a history of a modified Bentall procedure 24 years ago, reported to our outpatient clinic with recurrent inappropriate ICD shocks due to episodes of fast AF. The transthoracic echocardiographic exam revealed 2 large aneurysms at the ostia of the coronary arteries. We performed further evaluation with transesophageal echocardiogram (TOE) and computed tomography (CT) angiography. The aneurysms measured on CT were 3.14*2.29 cm on the right ostium and 1.9*0.99 cm on the left. A large secundum-type atrial septal defect (ASD) of 1.5 cm was revealed that was missed in all previous echocardiographic studies. The therapeutic options of surgical closure of the ASD and repair of the aneurysms or a more conservative approach with percutaneous closure of the ASD and closer follow-up were discussed with the patient. The patient declined the surgical option due to high complication risk, and closure of the ASD with an Amplatzer device was performed 3 months later. A 3 -year Follow-up was uneventful. Conclusion It is of major importance to comprehensively and thoroughly assess patients before and after a surgical intervention to not miss other treatable conditions preoperatively and complications in the postoperative period.

scholarly journals Cryoballoon Atrial Fibrillation Ablation in a Patient with an Atrial Septal Defect Closure Device

2021 ◽  
Author(s):  
Meisam Mokhtari ◽  
Zahra Khajali ◽  
Mona Heidarali ◽  
Majid Haghjoo
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Septal Defect ◽  
Closure Device ◽  
Atrial Septal Defect Closure ◽  
Occluder Device ◽  
Asd Closure

Atrial fibrillation (AF) is the most commonly treated arrhythmia in clinical practice and is often found in association with an atrial septal defect (ASD). However, ASD closure rarely confers complete arrhythmia control. A 23-year-old man presented to our center with frequent episodes of palpitations. AF was documented in 12-lead electrocardiography, and echocardiography showed a secundum-type ASD, 14 mm in size, with a significant left-to-right shunt. ASD closure was performed successfully with an ASD occluder device with no residual shunting. During follow-up, the patient experienced several episodes of AF. Thirteen months after the ASD closure, cryoballoon pulmonary vein isolation was done successfully with no complications. During a 12-month follow-up, he had no symptoms or AF recurrences, and echocardiography showed no residual shunting. This study showed that cryoballoon pulmonary vein isolation could be performed successfully without residual shunts in patients with ASD closure devices.

P4166Efficacy and safety of novel biodegradable device for closure of atrial septal defect: from preclinical study to first-in-man experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y F Li ◽  
Y M Xie ◽  
Z F Xie ◽  
S S Wang ◽  
B N Li ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Preclinical Study ◽  
Closure Device ◽  
Swine Model ◽  
Procedure Time ◽  
Short Term ◽  
The Mean ◽  
Asd Closure

Abstract Background closure of atrial septal defect (ASD) has emerged as the treatment of choice for the majority of defect. The biodegradable ASD closure device is a novel, absorbable device made of poly-L_latic acid (PLLA). This study evaluates the feasibility, safety and effectiveness of PLLA biodegradable ASD closure device in a swine model and for the first time in human. Objective The study reports on the 24- and 36- month follow-up results of PLLA device implanted in a swine model and the first-in- man experience with 6-month follow-up. Method Preclinical study was done in a swine ASD model. In a clinical setting, 5 pediatric patients with a secundum ASD who a clinically left-to-right shunt were enrolled in our center. Percutaneous ASD closure procedure with PLLA device was performed with fluoroscopic and transcatheter echocardiography (TTE) guidance. Procedure results and clinical outcomes at 1 day, 30 days, 3 months and 6 months after closure procedure were analyzed. Results 24- and 36-month follow-up results of preclinical study demonstrated that the PLLA device exhibited good endothelialization and degradability in a swine model. In clinical study, device implantation was successfully achieved in all of 5 patients (median age, 3.6 years; range, 3.1–6.5 years). The mean ASD size was (13.4±2.4)mm (range, 10–16mm). The mean pulmonary-to-systemic blood flow ratio (Qp:Qs) was (1.7±0.2):1 with a range of 1.5:1 to 2.0:1. The mean procedure time and the mean fluoroscopy time were (36.2±11.3) and (6.4±1.0)minutes, respectively. There was no evidence of short-term complications related to the device or the delivery system. No device dislodgement, significant aortic valve or mitral valve regurgitation, new onset cardiac arrhythmia, or other adverse events were reported. Characteristics and procedure data of the 5 patients who underwent ASD closure procedure with PLLA device Patient No. Age Weight Gender Defect size Qp:Qs Mean Pulmonary Pressure Device size (mm) Sheath (Fr) Procedure time Fluoroscopy time Immediate residual shunt (years) (kg) (mm) (mmHg) (mm) (Fr) (min) (min) 1 4.9 23.5 Male 17 1.7:1 22 24 12 52 7.6 None 2 3.1 10.0 Male 14 2.0:1 19 20 12 26 5.4 None 3 6.5 21.0 Male 15 1.8:1 22 20 12 31 6.0 None 4 3.2 14.5 Female 12 1.5:1 13 18 10 44 7.3 None 5 3.6 12.5 Male 10 1.5:1 17 14 10 28 5.5 None Conclusion This study is the first to demonstrate the feasibility, safety and effectiveness of PLLA biodegradable device in human, with no evidence of short-term complications and a high rate of early shunt closure. Acknowledgement/Funding National Key R&D Program of China (Grant Number: 2016 YFC1100305)

NEW-ONSET AND PERSISTENT MIGRAINE EARLY AFTER PERCUTANEOUS ATRIAL SEPTAL DEFECT CLOSURE DISAPPEAR AT FOLLOW-UP

2008 ◽  
Vol 63 (4) ◽  
pp. 262-268 ◽  
Author(s):  
A. Voet ◽  
J.G.L.M. Luermans ◽  
V. Thijs ◽  
L. Herroelen ◽  
M. C. Post ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Defect Closure ◽  
Atrial Septal Defect Closure ◽  
New Onset

scholarly journals Corynebacterium diphtheriae-infective endocarditis in a patient with an atrial septal defect closure device

2019 ◽  
Vol 12 (5) ◽  
pp. e229478 ◽  
Author(s):  
Jacinta Ng ◽  
Teesha Downton ◽  
Natalie Davidson ◽  
James Marangou
Keyword(s):  
Infective Endocarditis ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Corynebacterium Diphtheriae ◽  
Blood Cultures ◽  
Flank Pain ◽  
Closure Device ◽  
Atrial Septal Defect Closure ◽  
Asd Closure

An 18-year-old woman presented to our institution with fever, bilateral flank pain, headache and photophobia. She had a previous atrial septal defect (ASD) closure device inserted at the age of 9 years. Blood cultures on admission were positive forCorynebacterium diphtheriae, and transoesophageal echocardiogram (TOE) revealed an echodensity associated with the ASD closure device, most consistent with a vegetation. She was treated for infective endocarditis with 6 weeks of intravenous benzylpenicillin, and follow-up TOE showed resolution of the echodensity. To our knowledge, no cases ofC. diphtheriaeendocarditis of an ASD closure device have previously been reported.

scholarly journals Emergent surgical removal of a migrated atrial septal defect occluder: case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bi Wen ◽  
Juan He
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Major Complication ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Percutaneous Closure ◽  
Surgical Removal ◽  
Device Implantation ◽  
Occluder Device ◽  
Asd Closure

Abstract Background Atrial septal defect (ASD) closure has been widely accepted and is now routinely performed using a percutaneous approach under especially echocardiographic guidance Transesophageal echocardiography (TEE). One major complication is dislocation of occluder device during or after the device implantation. Surgical removal may be required, especially when the device stuck in the left ventricular outflow tract (LVOT). Case introduction A 21-year-old female was admitted to our department for percutaneous closure of secundum ASD. Percutaneous closure under the guidance of TEE was recommended for the patients. During device implantation, the TEE showed dislocation of the 22 mm ASD occluder device, stucked into the LVOT and behind the anterior mitral leaflet, producing severe LVOT obstruction Fig. 1). We herein present a safe and quick technique for surgical removal of an ASD occlude device located in the LVOT. Conclusion This technique provides a safe method for surgical removal of malposition and migration ASD occluder device.

scholarly journals Transcatheter Closure of Atrial Septal Defect with Amplatzer Device in Adolescence and Adults: Short Term Results: MCVTC Experience

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Heart Diseases ◽  
Device Closure ◽  
Short Term ◽  
Amplatzer Device ◽  
Invasive Cardiology

Introduction: Atrial septal defect (ASD) is one of the common congenital heart diseases accounting for 8% to 10% of total congenital heart disease at birth and one of the most common diseases in adulthood. Ostium Secundum (OS) ASD has been successfully closed surgically for over several decades. But even though the results are better, it is associated with discomfort, morbidity, and a thoracotomy scar. Transcatheter closure in these patients has advanced rapidly in recent years and represents a growing field in invasive cardiology. Methods: This prospective study was conducted at Manmohan cardiothoracic vascular and transplant center, Maharajgung, Kathmandu, Nepal. Fifty-two (52) patients with a diagnosis of OS ASD assessed for device closure. Patients underwent transthoracic and trans oesophageal echocardiography for the defect location, size, number, and associated anomalies. All patients with OS ASD fulfilling the inclusion criteria enrolled for device closure. The procedure conducted under fluoroscopy and transesophageal guidance. The cases were followed up at 3 and 6 months, reassessed clinically and by echocardiography for any complications. Results: The patients with ASD who enrolled in this study belonged to the age group of 14 to 63 years. The device closure attempted in 46 patients, and the remaining six patients excluded from the procedure due to unsuitable anatomy after GA guided TEE done. Among 46 patients, 44 (95%) had successful device closure. The mean age of the patient was 35.7+ 10 and 33 (71.7%) female, with 13 (28.3%) males. Conclusions: The transcatheter device closure of ASD in adolescents and adults has a high success rate with fewer complications and found to be safely documented during immediate and short term follow up. However, long terms follow up is required to conclude it.

scholarly journals Percutaneous Atrial Septal Defect Closure Using the Occlutech Figulla Device in Adults: More than 800 Patient-Years of Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
R. J. R. Snijder ◽  
L. E. Renes ◽  
D. Bosshardt ◽  
M. J. Suttorp ◽  
J. M. ten Berg ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Color Doppler ◽  
Atrial Septal Defect Closure ◽  
Closure Rate ◽  
Long Term Follow Up ◽  
Device Embolization ◽  
Asd Closure

Purpose. The Occlutech Figulla occluder has been proven safe and effective at midterm follow-up after percutaneous atrial septal defect (ASD) closure. We describe the safety and efficacy at long-term follow-up in adults. Methods. All consecutive adult patients that underwent ASD closure between 2008 and 2015 were included. All complications were registered. Residual left-to-right shunt (LRS) was diagnosed using color-Doppler transthoracic echocardiography (TTE). Right-to-left shunting was diagnosed using contrast TTE. Successful closure was defined as no LRS at follow-up. Results. In total, 166 patients (mean age 56.7 ± 16.1 years; 62% female) underwent percutaneous ASD closure using the Occlutech Flex I (70%) or Flex II (30%) device (diameter 24 mm; range 10–40 mm) under general anaesthesia and transoesophageal echocardiographic guidance. Long-term follow-up data were available for 144 patients (87%) with a mean follow-up of 5.9 ± 2.6 years, a total of 814 patient-years. During hospitalization, device embolization occurred in three patients (1.8%) with successful extraction in all. During the long-term follow-up, 15 patients (9.8%) suffered new-onset atrial fibrillation and stroke occurred in 2.1%. There was no residual LRS at 12-month follow-up. No device embolization occurred during the long-term follow-up. Conclusion. Percutaneous ASD closure using the Occlutech device appears to be safe at long-term follow-up with a high successful closure rate at one year.

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