Enlarged right ventricular size at 11 years follow-up after closure of secundum type atrial septal defect in children

AbstractObjectivesThe objective of this study was to demonstrate the safety and feasibility of using the new Cardia Ultrasept II™ device with interposed Goretex patch referring to the perforation of polyvinyl alcohol membrane.BackgroundGreat advances have been made in the development of devices for closure of atrial septal defect. The Cardia Ultrasept II™ with interposed Goretex patch is the modified last generation of Cardia devices, having the advantage of a super-low profile within the atria and an integral locking delivery-retrieval mechanism that ensures safe deployment. In addition, with the interposition of the Goretex, it has been possible to abolish perforation of Ivalon’s membrane as a complication.Methods and resultsPatients with ostium secundum atrial septal defect with surrounding rims with a minimum length of 5 mm and who underwent atrial septal defect closure with the new Ultrasept II™ with Goretex patch were included from two paediatric cardiac centres. Primary end point was to determine perforation of the Goretex membrane at follow-up; secondary end point included right ventricular diastolic diameter. In total, 30 patients underwent atrial septal defect closure at a median age of 6 (1–29) years. At follow-up for 6 (range, 1–15) months, freedom from perforations was 100%. A continuous decrease in right ventricular diastolic diameter was found with an initial median of 30 (25–49) mm and after catheterisation of 27.5 (18–33) mm, p=0.01, and Z-score of 2.6 (1.7–3.6) versus 1.9 (1–2.9) after procedure, p=0.01.ConclusionsThe new modified generation of the Ultrasept II™ device with interposed Goretex patch is a good alternative to achieve atrial septal defect closure safely and feasibly with no membrane perforation at follow-up.

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Stable right ventricular size and function during short-term follow-up in patients with pulmonary regurgitation after tetralogy of Fallot repair

Clinical Radiology ◽

10.1016/j.crad.2013.06.020 ◽

2013 ◽

Vol 68 (12) ◽

pp. 1206-1211 ◽

Cited By ~ 3

Author(s):

M. Śpiewak ◽

Ł.A. Małek ◽

J. Petryka ◽

E.K. Biernacka ◽

P. Hoffman ◽

...

Keyword(s):

Right Ventricular ◽

Tetralogy Of Fallot ◽

Pulmonary Regurgitation ◽

Ventricular Size ◽

Short Term ◽

Right Ventricular Size ◽

And Function ◽

Tetralogy Of Fallot Repair

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Enlarged right ventricular size at 11 years’ follow-up after closure of secundum-type atrial septal defect in children

Cardiology in the Young ◽

10.1017/s1047951112000480 ◽

2012 ◽

Vol 23 (1) ◽

pp. 7-13 ◽

Cited By ~ 8

Author(s):

Wilfred B. de Koning ◽

Lennie M. van Osch-Gevers ◽

Danielle Robbers-Visser ◽

Ron T. van Domburg ◽

Ad J.J.C. Bogers ◽

...

Keyword(s):

Right Ventricular ◽

Atrial Septal Defect ◽

Exercise Testing ◽

Septal Defect ◽

Systolic Volume ◽

Surgical Closure ◽

End Systolic Volume ◽

The Mean ◽

Ventricular Dimensions

AbstractBackgroundThe fate of right ventricular dimensions after surgical closure of secundum-type atrial septal defects remains unclear. The objectives of this study were to assess ventricular dimensions, exercise capability, and arrhythmias of patients operated for secundum-type atrial septal defect and compare the results with those in healthy references.MethodsA total of 78 consecutive patients underwent surgical closure for a secundum-type atrial septal defect between 1990 and 1995. In all, 42 patients were included and underwent a cross-sectional evaluation including echocardiography, magnetic resonance imaging, exercise testing, and 24-hour ambulatory electrocardiography. Patients were matched with healthy controls for gender, body surface area, and age.ResultsThe mean age at surgery was 4.6 plus or minus 2.8 years, and the mean age at follow-up was 16 plus or minus 3 years. There were no residual intracardiac lesions. The mean right ventricular end-systolic volume was significantly larger in patients (142 ± 26 millilitres) than in references (137 ± 28 millilitres; p = 0.04). In 25% of the patients, right ventricular end-systolic volume was larger than the 95th percentile for references. No relevant arrhythmias were detected. Exercise testing did not reveal differences with healthy references: maximal power (169 ± 43 Watt patients versus 172 ± 53 controls; p = 0.8), maximal oxygen uptake (38 ± 8 versus 41 ± 13 millilitres per minute per kilogram; p = 0.1).CommentAfter surgical closure of secundum-type atrial septal defect, right ventricular end-systolic volume is increased. These findings have no impact on rhythm status or exercise capacity at this stage of follow-up, but may have implications for the timing of surgery or the technique of closure if confirmed in longer follow-up.

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Transcatheter closure of atrial septal defect associated with arrhythmogenic right ventricular cardiomyopathy: a case report and literature review

Cardiology in the Young ◽

10.1017/s1047951114001553 ◽

2014 ◽

Vol 25 (3) ◽

pp. 403-407

Author(s):

Haiyan Wang ◽

Hongyu Ding ◽

Lei Lei ◽

Xiaohong Zhang ◽

Yuling Gong ◽

...

Keyword(s):

Right Ventricular ◽

Atrial Septal Defect ◽

Ventricular Arrhythmias ◽

Septal Defect ◽

Medical Literature ◽

Transcatheter Closure ◽

Arrhythmogenic Right Ventricular Cardiomyopathy ◽

Interventional Treatment ◽

Ventricular Cardiomyopathy

AbstractArrhythmogenic right ventricular cardiomyopathy is characterised by progressive, fibrofatty replacement of myocardium, and ventricular arrhythmias, and its prognosis is usually poor. Arrhythmogenic right ventricular cardiomyopathy associated with atrial septal defect is very rare, and this combination may make the diagnosis, treatment, and prognosis difficult. We present a case of a patient with this association who underwent interventional treatment with a septal defect occluder. Transcatheter closure of atrial septal defect in a patient with arrhythmogenic right ventricular cardiomyopathy is hitherto unreported. During a 3-year follow-up he remained relatively stable. We also review the cases reported in the medical literature describing this uncommon association between arrhythmogenic right ventricular cardiomyopathy and atrial septal defect or patent foramen ovale.

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Incidence and clinical relevance of persistent iatrogenic atrial septal defect after percutaneous mitral valve repair

Scientific Reports ◽

10.1038/s41598-021-92255-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mhd Nawar Alachkar ◽

Anas Alnaimi ◽

Sebastain Reith ◽

Ertunc Altiok ◽

Jörg Schröder ◽

...

Keyword(s):

Mitral Valve ◽

Right Ventricular ◽

Atrial Septal Defect ◽

Mitral Valve Repair ◽

Septal Defect ◽

Valve Repair ◽

Percutaneous Mitral Valve Repair ◽

Significant Difference ◽

Iatrogenic Atrial Septal Defect

AbstractPercutaneous mitral valve repair (PMVR) requires transseptal puncture and results in iatrogenic atrial septal defect (iASD). The impact of persistent iASD was previously investigated. However, data were diverse and inconclusive. 53 patients who underwent MITRACLIP were retrospectively included. Based on the presence of iASD in transesophageal echocardiography (TEE) after 6 months, patients were divided in two groups (iASD group vs. non-iASD group). Impact of iASD on outcome at 6 months and at two years was evaluated. Persistent iASD was detected in 62% of patients. Independent predictors for persistent iASD were female gender and reduced left ventricular ejection fraction. At 6-month follow-up, there was no difference in reduction of NYHA class (ΔNYHA = 1.3 ± 1 in iASD group vs. 0.9 ± 1 in non-iASD group, p = 0.171). There was a significant difference in right ventricular end diastolic diameter (RVEDd) (42 ± 8 mm in iASD-group vs. 39 ± 4 mm in non-iASD group, p = 0.047). However, right ventricular systolic function (TAPSE) (14 ± 7 mm in iASD group vs. 16 ± 8 mm in non-iASD group, p = 0.176) and right ventricular systolic pressure (RVSP) (40 ± 12 mmHg in iASD group vs. 35 ± 10 mmHg in non-iASD group, p = 0.136) were still comparable between both groups. At 2 years follow-up, there was no significant difference regarding rate of rehospitalization (24% vs 15%, p = 0.425) or mortality (12% vs 10%, p = 0.941) between both groups. Incidence of persistent iASD after MITRACLIP is markedly high. Despite the increase in right ventricular diameter in patients with persistent iASD, these patients were not clinically compromised compared to patients without persistent iASD.

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Surgical Strategy in Patients with Atrial Septal Defect and Severe Pulmonary Hypertension

The Heart Surgery Forum ◽

10.1532/hsf98.20111085 ◽

2012 ◽

Vol 15 (2) ◽

pp. 111 ◽

Cited By ~ 9

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.

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