scholarly journals Features of endovascular closure of secondary atrial septal defect in older patients

2020 ◽  
Vol 22 (10) ◽  
pp. 64-68
Author(s):  
Ilya A. Kovalchuk ◽  
◽  
Ionatan R. Rafaeli ◽  
Aleksey V. Azarov ◽  
Sergey P. Semitko ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Economic Effect ◽  
Adult Patients ◽  
Long Term Results ◽  
Right Heart ◽  
Heart Rhythm Disorders ◽  
The Right

Aim. Secondary atrial septal defect (ASD II) is one of the most common congenital heart defects. While all the issues of endovascular correction of this disease in children and young patients have been practically resolved, many issues still remain debatable regarding the treatment of adult patients. In the proposed work, the author analyzes the main information’s discussed in the literature concerning this issue, such as the expediency and tactics of treatment of adult patients with ASD II, depending on its anatomical forms, the status of intracardiac and pulmonary-arterial hemodynamics, the presence of concomitant diseases. Materials and methods. The article presents a literature review based on the results of searching of publications in Russian and international bibliographic da-tabases (PubMed, eLIBRARY, Medscape, etc.). Results. Analysis of the literature data in most cases indicates the feasibility and high efficiency of endovascular closure of hemodynamically significant ASD II in elderly patients. The analysis of dynamic observations in the long term after endovascular treatment, reveals a decrease in MPAP as well as the size of the right heart. At the same time, compliance with certain rules makes the intervention quite safe, regardless of the age of patients and, to a certain extent, the severity of symptoms. In the literature, it is particularly emphasized that when determining the management tactics of adult patients with ASD II in order to prevent possible complications, should be objectively evaluated and taken into account such factors that determine their initial state as: the presence of high MPAP, volume overload of the right heart, and vice versa, underloading of the left heart, the conditions of the heart valves, the presence of arterial hypertension, existence of heart rhythm disorders, ischemic heart disease and left ventricle dysfunction. Conclusion. Modern medical literature convincingly proves that with the right selection of patients, transcatheter closure is a safe, highly effective method of correction of ASD II, accompanied by real economic effect and it should be considered a standard in the treatment of middle-aged and elderly patients. At the same time, studies on long-term results show that the positive functional effect does not have age restrictions.

Abstract 2130: Long-term Outcomes of Adult Atrial Septal Defect With Severe Pulmonary Hypertension After Surgical Closure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jeong-Hoon Kim ◽  
Duk-Hyun Kang ◽  
Jong-Young Lee ◽  
Jong-Min Song ◽  
Tae-Jin Yun ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Survival Rates ◽  
Severe Pulmonary Hypertension ◽  
Term Survival ◽  
Surgical Closure

The benefits of surgical closure has been unclear in adult atrial septal defect (ASD) with severe pulmonary hypertension (PHT), and we tried to evaluate improvement of PHT and long-term survival after surgical closure compared to medical follow-up. Methods: From 1996 to 2006, we included a total of 71 adult ASD patients (age; 43±15 years) with severe PHT documented by echocardiography. The inclusion criteria were defined as ASD diameter > 15 mm, enlarged right ventricle, and the baseline peak velocity of tricuspid regurgitation (TR) ≥ 4.0 m/sec. We excluded 5 patients with Eisenmenger syndrome documented by cardiac catheterization. Surgical closure was performed on 55 patients (OP group) and the remaining 16 patients were followed up medically (MED group). The improvement of PHT was defined as TR velocity ≤ 3.5 m/sec on follow-up echo. Results: Baseline characteristics and clinical results were compared between the two groups in table . There were no significant differences in terms of gender, ASD diameter, cardiac rhythm, and TR velocity, but the MED group was significantly older. During follow-up of 46±33 months, there were 5 deaths in the MED group and no operative or late death in the OP group, and the 5-year actuarial survival rate of the OP group was significantly higher than the MED group (58±15%, p<0.05). On subgroup analysis according to age, the OP group showed significantly better survival rates than the MED group (p<0.05) in elderly patients (age > 50). In the OP group, TR velocity was significantly decreased from 4.5±0.4 to 3.0±0.7 m/sec on follow-up echo, and improvement of PHT was observed in 47 (85%) patients. On multivariate analysis, female gender and lower baseline TR velocity were the significant independent predictors of improved PHT after surgery. Conclusions: In adult ASD with severe PHT, surgical closure can be safely performed and improve PHT effectively. Especially in elderly patients, ASD closure is significantly related with the better survival rates.

scholarly journals Surgical treatment of adult atrial septal defect: Early and long-term results

1992 ◽  
Vol 20 (5) ◽  
pp. 1156-1159 ◽  
Author(s):  
Keith A. Horvath ◽  
Redmond P. Burke ◽  
John J. Collins ◽  
Lawrence H. Cohn
Keyword(s):  
Surgical Treatment ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Long Term Results

scholarly journals Long-term results of transcatheter closure of large secundum atrial septal defect: comparison of intraoperative device closure

Heart ◽  
2011 ◽  
Vol 97 (Suppl 3) ◽  
pp. A209-A209
Author(s):  
G. Jinjian ◽  
Y. Xiaoping ◽  
L. Chaogui ◽  
P. Yafei ◽  
L. Yukun ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Long Term Results ◽  
Secundum Atrial Septal Defect ◽  
Device Closure

scholarly journals Very long-term results of electroanatomic-guided radiofrequency ablation of atrial arrhythmias in patients with surgically corrected atrial septal defect

EP Europace ◽  
2014 ◽  
Vol 16 (12) ◽  
pp. 1800-1807 ◽  
Author(s):  
Marco Scaglione ◽  
Domenico Caponi ◽  
Elisa Ebrille ◽  
Paolo Di Donna ◽  
Francesca Di Clemente ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Long Term Results ◽  
Atrial Arrhythmias

COMPARATIVE EVALUATION OF IMMEDIATE RESULTS OF PLASTIC ATRIAL SEPTAL DEFECT IN ADULT PATIENTS, LIVING IN HIGH ALTITUDE CONDITIONS

2021 ◽  
pp. 16-21
Author(s):  
Kaldarbek Abdramanov ◽  
◽  
Emilbek Kokoev ◽  
Emir Alimbekov ◽  
Parida Arzibaeva ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Atrial Septal Defect ◽  
High Altitude ◽  
Septal Defect ◽  
Adult Patients ◽  
Control Group ◽  
Observation Data ◽  
Clinical Methods ◽  
Pulmonary Arterial ◽  
The Right

The article gives a comparative assessment of the results of surgery for atrial septal defect (ASD) surgery in patients living in low and high altitude conditions. sizes of the right ventricle were practically equal, but at the same time higher than the norm. Objective. To conduct a comparative analysis of the direct results of ASD plastic in patients living in low, medium and high mountains Material and methods. The study material included 30 patients with ASD living in highlands; the control group consisted of 30 patients living in flat areas. Using clinical methods and instrumental studies, an analysis of operated patients, ASD plastic in adult patients with complicated pulmonary hypertension, heart failure, cardiac arrhythmias and functional tricuspid insufficiency was performed. Results. The authors studied pulmonary arterial pressure (PAP) indices between the groups both in the preoperative and postoperative periods, the analysis showed significant differences. The parameters of the right ventricle (RV) in the preoperative period had significant differences, however, in the postoperative period, the sizes of the right ventricle were practically equal, but at the same time higher than the norm. Conclusion. Our observation data show a significant decrease in PAP in patients living in high altitude conditions. However, the decrease in the PAP indicators remained slightly higher than the standard indicators.

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