scholarly journals Atrial Septal Defect Device Closure in Patients with Metabolic Diseases or Genetic Syndromes

2021 ◽  
Author(s):  
Keyhan Sayadpour Zanjani ◽  
Morteza Heidari ◽  
Nima Nazari ◽  
Reihaneh Mohsenipour
Keyword(s):  
Atrial Septal Defect ◽  
Genetic Disease ◽  
Septal Defect ◽  
Metabolic Diseases ◽  
Careful Attention ◽  
Thromboembolic Events ◽  
Genetic Syndromes ◽  
Device Closure ◽  
Device Embolization

Concomitant metabolic or genetic syndromes can make atrial septal defect device closure difficult. We searched our database and found eight. The cohort consists of patients with different metabolic and genetic disease . Thromboembolic events and device embolization occurred in some patients. Careful attention is recommended in patients with special diseases.

scholarly journals Very large Atrial Septal Defect Device Closure: Feasibility and safety

2021 ◽  
Vol 42 (2) ◽  
Author(s):  
Goutam Datta
Keyword(s):  
Pericardial Effusion ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Volume Overload ◽  
Ventricular Volume ◽  
Percutaneous Closure ◽  
Device Closure ◽  
Device Embolization ◽  
Male Patients ◽  
Device Size

Objectives: There is limited data regarding feasibility and safety of very large ASD devices deployment. Percutaneous closure of very large atrial septal defect (ASD) is a valid alternative to surgical approach.  But complications like erosion, cardiac perforation, atrioventricular block, pericardial effusion, infective endocarditis, or cardiac arrhythmias may occur following ASD device closure.  Methods: Forty four patients with very large ostium secundum ASD were studied in a tertiary medical centre. Adult patients with defect size of 38 mm or more and device size of 40 mm or more were selected for device closure. Patients having suitable anatomy, significant left to right shunt(>1.5:1) ,right ventricular volume overload and without significant pulmonary arterial hypertension were chosen for device closure. Results : There were thirty six  female patients and  eight  male patients in our study. Majority of our patients (twenty four) were in forty to fifty years age group. Device could be deployed successfully in forty two (95.5%).  Twelve patients had device size of 46 mm (27%). Eight patients had 44 mm devices(18%). Forty two millimeter devices were used in sixteen patients (36%). Eight  patients had device size of  40 mm(18%).Device embolization occurred in two patients. There were two cases of pericardial effusion and pericardiocentesis was needed in one patients. Transient complete heart block was seen in one patient. Four patients had suffered from transient and self terminating atrial arrhythmias. There was no mortality or erosion in our study. Conclusion: Percutaneous closure of very large ASD is feasible and associated with low complication rate

scholarly journals Successful Percutaneous Retrieval of Embolised Septal Occluder Device and Device Closure of Atrial Septal Defect in Combined Procedure

2019 ◽  
pp. 1-9
Author(s):  
Gurkirat Singh ◽  
Mahesh Bodkhe ◽  
Akshat Jain ◽  
Narender Omprakash Bansal
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Device Closure ◽  
Hemodynamic Compromise ◽  
Septal Occluder Device ◽  
Device Embolization ◽  
Occluder Device ◽  
Transcatheter Device

Transcatheter device closure is the treatment of choice in patients with secundum atrial septal defects with adequate rims. It is technically safe, feasible and has the obvious advantage of being a nonsurgical technique. Patient is free from the scar especially young, unmarried females. It is not free of complications. Device embolization and arrhythmias are the major complications. Embolised device can cause hemodynamic compromise by obstructing the blood flow if it gets embolised in pulmonary artery. We report a case of 24 year old female, taken for device closure of atrial septal defect. Device gets embolised in pulmonary artery causing hemodynamic compromise by causing obstruction to blood flow. This embolised device was successfully retrieved percutaneously. The atrial septal defect was closed with one size larger device, in the same sitting. Patient is asymptomatic and is free from any scar.

Surgical perspective of percutaneous device closure of atrial septal defect

2018 ◽  
Vol 26 (5) ◽  
pp. 343-346
Author(s):  
Shyam Kumar Singh Thingnam ◽  
Sachin Mahajan ◽  
Vikas Kumar
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Device Closure ◽  
Atrial Septal Defect Closure ◽  
Surgical Closure ◽  
Risk Of Death ◽  
Percutaneous Device ◽  
Device Embolization ◽  
Percutaneous Device Closure

Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal complications as well as lifelong follow-up. Surgical intervention is required in cases of device-related complications, which carries a slightly higher risk compared to primary closure of an atrial septal defect. We present a surgical perspective of device closure of atrial septal defect. Methods Our database was searched over 4 years for complications related to percutaneous device closure of atrial septal defect, which required surgical retrieval of the device and closure of the defect. We identified 14 cases that required surgical intervention. Results The median age of the 14 patients was 18 years (range 4–58 years). The size of the defect ranged from 15 to 40 mm (median 30 mm). Device embolization into any part of the cardiovascular system ( n = 8) was the most common complication, followed by malalignment of the device ( n = 5). One patient had left atrial appendage perforation causing pericardial effusion and cardiac tamponade, and underwent surgical repair. The other 13 patients underwent removal of the device and atrial septal defect closure. One patient developed severe mitral regurgitation requiring mitral valve replacement. There was no mortality. Conclusion Although the incidence of device-related complications may be small, they carry a high risk of death or long-term morbidity, even with a small atrial septal defect, unlike primary surgical closure of isolated atrial septal defect.

Acute Changes in Left Ventricular End Diastolic Pressure following the Transcatheter Closure of an Atrial Septal Defect in Adults

2016 ◽  
Vol 19 (3) ◽  
pp. 145 ◽  
Author(s):  
Young Hwa Kong ◽  
Jinyoung Song ◽  
Kyung Hee Kim ◽  
June Huh ◽  
I-Seok Kang
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Device Closure ◽  
Acute Changes ◽  
Asd Closure

<strong>Background:</strong> Acute changes in left ventricular diastolic function shortly after ASD closure in elderly patients have not been well known. We aimed to investigate acute changes in left ventricular end diastolic pressure (LVEDP) in elderly patients following transcatheter closure of atrial septal defect (ASD). <br /><strong>Methods:</strong> All 19 adults with ASDs who underwent transcatheter closure between June 2013 and December 2014 were enrolled. LVEDP was measured prior to device closure and compared with that immediately following device closure and 15 minutes after device closure. <br /><strong>Results:</strong> The median age of the patients was 48 years old. The baseline E/e’ and LVEDP values were 8.3 ± 2.8 and 13 ± 3 mmHg. The LVEDP value immediately following closure was 19 ± 4 mmHg, and 15 minutes after closure was 16 ± 4 mmHg. The median increase in the LVEDP value immediately following closure was 6 mmHg, which significantly differed from that prior to closure. The LVEDP 15 minutes after closure decreased but remained significantly higher than the value observed immediately after closure. No significant changes were observed with regard to E/e’ at either 1 day or 3 months following closure. The LVEDP value <br />15 minutes after device closure was significantly correlated with those observed before closure and immediately following closure; however, no significant correlations were observed with regard to patient age, Qp/Qs, E/e’ before closure, or E/e’ 3 months after device closure.<br /><strong>Conclusion:</strong> LVEDP in adults with ASDs significantly increases following device closure. LVEDP before closure predicts LVEDP following device closure.

Use of Mullins sheath to prevent prolapse of Gore Cardioform ASD Occluder in a child with severe scoliosis

2020 ◽  
pp. 1-3
Author(s):  
Christopher Herron ◽  
Daisuke Kobayashi
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Device Closure ◽  
Severe Scoliosis ◽  
The Right ◽  
Transcatheter Device ◽  
Delivery Catheter

Abstract Transcatheter device closure of an atrial septal defect (ASD) may require an additional supportive technique in challenging cases. We report a 15-year-old male with moderate-sized ASD and severe scoliosis. In spite of adequate positioning of the Gore Cardioform ASD occluder, the device was pulled into the right atrium by a retrieval cord due to the acute release of strong tension between the delivery catheter and its device upon locking. This phenomenon was prevented by the use of Mullins sheath, resulting in a successful release of the device. The use of a Mullins sheath may be considered to deliver a Gore Cardioform ASD device in selected cases.

Impact of Transcatheter Device Closure of Atrial Septal Defect on Atrial Arrhythmias Propensity in Young Adults

2019 ◽  
Vol 41 (1) ◽  
pp. 54-61
Author(s):  
Michel Cabrera Ortega ◽  
Dunia Bárbara Benítez Ramos ◽  
Juan Carlos Ramiro Novoa ◽  
Francisco Javier Ozores Suarez ◽  
Francisco Díaz Ramírez ◽  
...  
Keyword(s):  
Young Adults ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Atrial Arrhythmias ◽  
Device Closure ◽  
Transcatheter Device

scholarly journals Case report: echocardiographic detection of rare single coronary artery anomaly in a child with an atrial septal defect

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Rachel Hazaert ◽  
Nigel Wilson ◽  
Kathryn Rice
Keyword(s):  
Coronary Artery ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Incidental Finding ◽  
Dobutamine Stress ◽  
Single Coronary Artery ◽  
Device Closure ◽  
Coronary Artery Anatomy ◽  
Transcatheter Device ◽  
Single Coronary Artery Anomaly

Abstract Background A single right coronary artery (RCA) with the left anterior descending (LAD) and circumflex coronary arteries located in the usual anatomic position and supplied by collaterals is the rarest variant of single RCA. Case summary We report a paediatric patient with an incidental finding of single RCA Lipton type RI pattern during assessment for transcatheter device closure of an ostium secundum atrial septal defect (secASD). Transthoracic echocardiography (TTE) revealed a dilated RCA, abnormal flow in the LAD, and no identifiable left main coronary artery. Diagnosis of a single RCA was confirmed with angiography. Dobutamine stress echocardiography revealed no inducible ischaemia. Transcatheter device closure of the secASD was subsequently successfully performed. Discussion TTE in paediatric patients can raise suspicion of coronary artery origin anomalies. Additional modalities, such as computed tomography and angiography, are required to comprehensively determine coronary artery anatomy. Functional assessment of ventricular function is also indicated. Coronary artery anatomy is important to delineate prior to transcatheter device closure of a secASD and should be part of the pre-procedure assessment.

scholarly journals Acute Unilateral Renal Infarction in the Setting of an Inherited Thrombophilia and Atrial Septal Defect

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Siavash Piran ◽  
Sam Schulman
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Paradoxical Embolism ◽  
Prothrombin G20210a ◽  
Renal Infarction ◽  
Suspected Case ◽  
Device Closure ◽  
Inherited Thrombophilia ◽  
History Of

We present a case of renal infarction in a 43-year-old female with history of stroke at age 14. She was found to be heterozygous for the prothrombin G20210A gene mutation. Loop monitoring revealed no atrial fibrillation. Transthoracic and transesophageal echocardiograms showed no thrombus. However, there was a small shunt due to an atrial septal defect (ASD). She was treated with warfarin and had device closure of her ASD. This was a suspected case of paradoxical embolism through an ASD leading to renal infarction.

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