The 'aortic rim' recount: embolization of interatrial septal occluder into the main pulmonary artery bifurcation after atrial septal defect closure

Background: Atrial septal defect and its closure can lead to changes in the right and left cardiac cavities' function and size. In this study, Z-scores of the cardiac chambers and the heart function were assessed, and the important complications were mentioned. Methods: This interventional cross-sectional study was done on patients who had atrial septal defect closure aged younger than 18 years. All patients were recruited for transthoracic echocardiography. About half of the patients were randomly selected. The information of angiography and its side effects belong to all patients, but the echocardiographic parameters and Z-scores belong only to the selected group. Results: A total of 370 patients underwent the atrial septal defect closure, of whom 150 patients participated in the study. The patients' average age and weight were 9.25 ± 3.44 years and 15.12 ± 11.83 kg, respectively, and the mean follow-up time was 2.56 years. Z-scores of the interventricular septal dimension in diastole, the left ventricular posterior wall dimension in diastole, the left ventricular internal dimension in systole, and Z-scores of the size of the right atrium, right ventricle, pulmonary valve annulus, and the main pulmonary artery were more than Z-scores of the normal population. Furthermore, Z-scores of the E/A and the Eat/Aat of the tricuspid valve were less than their peers. Besides, the correlation between Z-scores and the atrial septal defect size and weight of the patients was assessed, which was statistically significant, and patients who underwent atrial special defect closure at the age of fewer than three years and less than 15 kg had more normal cardiac Z-scores. Conclusions: Z-scores of the cardiac chambers and pulmonary artery were more than normal after successful closure of the atrial septal defect in the mid-term follow-up.

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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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Subacute, Silent Embolization of Amplatzer Atrial Septal Defect Closure Device to the Pulmonary Artery

Journal of Cardiovascular Ultrasound ◽

10.4250/jcu.2012.20.4.201 ◽

2012 ◽

Vol 20 (4) ◽

pp. 201 ◽

Cited By ~ 7

Author(s):

Jang-Won Son ◽

Jong-Seon Park

Keyword(s):

Pulmonary Artery ◽

Atrial Septal Defect ◽

Septal Defect ◽

Closure Device ◽

Defect Closure ◽

Atrial Septal Defect Closure

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

Congenital Heart Disease ◽

10.1111/j.1747-0803.2008.00245.x ◽

2009 ◽

Vol 4 (1) ◽

pp. 17-20 ◽

Cited By ~ 16

Author(s):

Sergey Yalonetsky ◽

Avraham Lorber

Keyword(s):

Pulmonary Artery ◽

Atrial Septal Defect ◽

Pulmonary Artery Pressure ◽

Tricuspid Valve ◽

Septal Defect ◽

The Elderly ◽

Defect Closure ◽

Valve Regurgitation ◽

Atrial Septal Defect Closure ◽

Tricuspid Valve Regurgitation

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Retrieval of the Atrial Septal Defect Closure Device Embolized to Pulmonary Artery

Kosuyolu Heart Journal ◽

10.5578/khj.9941 ◽

2017 ◽

Vol 20 (2) ◽

pp. 153-156

Author(s):

Selim Durmaz ◽

Tünay Kurtoğlu ◽

Hasan Güngör ◽

Muhammet Hüseyin Erkan ◽

Muharrem İsmail Badak

Keyword(s):

Pulmonary Artery ◽

Atrial Septal Defect ◽

Septal Defect ◽

Closure Device ◽

Defect Closure ◽

Atrial Septal Defect Closure

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A CASE OF SUCCESSFUL TREATMENT OF A PATIENT WITH HIGH PULMONARY HYPERTENSION BY IMPLANTATION OF AN OCCLUDER IN AN ATRIAL SEPTAL DEFECT

Siberian Medical Journal ◽

10.29001/2073-8552-2018-33-4-136-142 ◽

2019 ◽

Vol 33 (4) ◽

pp. 136-142

Author(s):

D. A. Korzh ◽

A. N. Samko ◽

M. G. Gorbunov ◽

A. A. Larionov ◽

D. P. Gaponov ◽

...

Keyword(s):

Pulmonary Artery ◽

Atrial Septal Defect ◽

Septal Defect ◽

Systolic Pressure ◽

Pulmonary Artery Systolic Pressure ◽

Closure Device ◽

Defect Closure ◽

Atrial Septal Defect Closure ◽

X Ray ◽

Device Implantation

Aim: the purpose of this publication is to demonstrate the safety and efficacy of the endovascular method of treatment for long-existing, neglected, and fairly common congenital heart defects such as an atrial septal defect with high pulmonary hypertension.Material and Methods. We present a clinical case of the successful X-ray endovascular treatment of a 48-year-old female patient with a high pulmonary hypertension diagnosed with congenital heart disease, atrial septal defect. Clinical and instrumental examination included standard resting electrocardiography, echocardiography, and catheterization of the right heart and the pulmonary artery. Surgical treatment consisted in an X-ray endovascular implantation of the 40-mm atrial septal defect closure device via the transfemoral access. Post-operative follow up care lasted for 15 months.Results. Echocardiography study showed the left ventricular ejection fraction of 53 mL; congenital heart disease was characterized by 2.5-cm secondary central atrial septal defect and a variable pressure release. Pulmonary artery systolic pressure was 120 mmHg. Catheterization of the right heart and the pulmonary artery showed blood flow with the presence of leftto-right shunting equal to Qp/Qs=2.0/1. An X-ray endovascular atrial septal defect surgery was conducted in an X-ray operation room via a standard transfemoral access. The surgery consisted in X-ray endovascular atrial septal defect occlusion with an implantation of an atrial septal defect closure device with 40-mm neck diameter. Intraoperative echocardiography study showed that the closure device was placed correctly with no signs of residual bleeding. The final echocardiography performed in three days showed the condition after atrial septal defect closure device implantation. The defect was tightly closed. Pulmonary artery systolic pressure was 83 mmHg. Hospital stay lasted for three days. Follow-up echocardiography study at 15 months showed the condition after atrial septal defect closure device implantation. The defect was tightly closed. Pulmonary artery systolic pressure was 46 mmHg.Conclusion. There are currently two types of treatment: open surgery such as suturing or plastic urgery with extracorporeal blood circulation and X-ray endovascular occlusion of the atrial septal defect by implantation of a special device. The X-ray endovascular treatment of an atrial septal defect with a closure device implantation is a highly effective and safe procedure. The main advantages of this method are as follows: surgery does not require anesthesia, incision, and heart-lung bypass whereas reimplantation and repositioning of the device is always feasible.

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