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

Prolonged repolarization in atrial septal defect: An example of mechanoelectrical feedback due to right ventricular volume overload

Heart Rhythm ◽  
2016 ◽  
Vol 13 (6) ◽  
pp. 1303-1308 ◽  
Author(s):  
Kristina Rücklová ◽  
Karel Koubský ◽  
Viktor Tomek ◽  
Peter Kubuš ◽  
Jan Janoušek
Keyword(s):  
Right Ventricular ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Volume Overload ◽  
Ventricular Volume ◽  
Right Ventricular Volume

Experience of transcatheter device closure of atrial septal defect in a tertiary care institute

2021 ◽  
pp. 1-12
Author(s):  
Muhammad Younas ◽  
Ahsan Beg ◽  
Tauseef Asma ◽  
Baqir Maqbool
Keyword(s):  
Pericardial Effusion ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Tertiary Care ◽  
Safe Procedure ◽  
Device Closure ◽  
Cross Sectional ◽  
Female Ratio ◽  
Transcatheter Device ◽  
Small Pericardial Effusion

Abstract Objective: To share our experience of transcatheter device closure of secundum atrial septal defect in children and adults. Methods: This descriptive cross-sectional study was conducted at department of Paediatric Cardiology Ch. Pervaiz Elahi Institute of Cardiology Multan from 2011 to September 2019. Patients with moderate to large ASD secundum without severe pulmonary hypertension were studied. All procedures were performed under general anaesthesia and trans-Oesophageal echo guidance. Success and safety of procedure were evaluated. Results: During study period, a total of 75 patients underwent ASD device closure. Mean age was 25 ± 1.53 (4 -54 years) and male to female ratio 1:2. Mean defect was 20.38 ± 0.58 (09 to 32 mm). Large defects (> 25 mm) were 17 (22.7 %). Significant PS (> 30 mm Hg) observed in three and valvuloplasty performed. Device size was selected on the basis of TOE measurement + 4-5 mm. Balloon sizing was performed in only three patients. Amplatzer   septal occluder was used in 80 %. Balloon assisted technique was used in 09 (12 %) patients. All the procedures were successful except two (2.7 %) where device embolized and retrieved by surgery. Transient arrhythmias were observed in 05 (6.6 %) and small pericardial effusion which was managed conservatively in one patient. There was no procedure related mortality. Conclusion: Transcatheter closure of moderate to large ASD secundum in children and adults is a safe procedure. Among the major events, device embolizaion was common. Other complications were rare including small pericardial effusion and transient arrhythmias. Continuous...

Combined hybrid pulmonary valve placement and atrial septal defect closure: case report and literature review

2020 ◽  
Vol 30 (5) ◽  
pp. 737-739
Author(s):  
Omar Abu-Anza ◽  
Kaitlin Carr ◽  
Osamah Aldoss
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Pulmonary Valve ◽  
Pulmonary Regurgitation ◽  
Volume Overload ◽  
Pulmonary Valve Replacement ◽  
Device Closure ◽  
Atrial Septal Defect Closure ◽  
Valve Placement ◽  
The Right

AbstractWe report a case of a 15-year-old female who underwent combined hybrid pulmonary valve replacement and transcatheter atrial septal defect device closure, which was performed due to severe volume overload of the right side of the heart secondary to pulmonary regurgitation and atrial septal defect.

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.

scholarly journals Clinical Significance of Septal Malalignment for Transcatheter Closure of Atrial Septal Defect

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yoichi Takaya ◽  
Teiji Akagi ◽  
Koji Nakagawa ◽  
Rie Nakayama ◽  
Takashi Miki ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Clinical Significance ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Adult Patients ◽  
Device Embolization ◽  
Septum Primum ◽  
Device Size ◽  
Selection Of ◽  
Septum Secundum

Background. Septal malalignment is related to erosion and device embolization in transcatheter closure of atrial septal defect (ASD), but limited information is available. Objectives. This study aimed to assess clinical significance of septal malalignment and to determine appropriate evaluation of ASD diameter, including the selection of device size. Methods. Four hundred and seventeen patients with ASD who underwent transcatheter closure were enrolled. Septal malalignment was defined as separation between the septum primum and the septum secundum on transesophageal echocardiography. Results. One hundred and eighty-four patients had septal malalignment. The frequency of septal malalignment increased with age reaching around 50% in adult patients. Septal malalignment was related to aortic rim deficiency. The distance of separation between the septum primum and the septum secundum was 5 ± 2 mm (range, 1–11 mm). In patients with septal malalignment, the ASD diameter measured at the septum primum was 19 ± 6 mm, while the ASD diameter measured at the septum secundum was 16 ± 6 mm. There was a difference of 4 ± 2 mm (range, 0–8 mm) between the ASD diameter measured at the septum primum and that measured at the septum secundum. For transcatheter closure, the Amplatzer Septal Occluder device size 2-3 mm larger and the Occlutech Figulla Flex II device size 4–7 mm larger than the ASD diameter measured at the septum primum were frequently used. During the study period, erosion or device embolization did not occur in all of the patients. Conclusions. Septal malalignment is highly prevalent in adult patients with aortic rim deficiency. The measurement of ASD diameter at the septum primum can be valuable for the selection of device size in patients with septal malalignment.

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.

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