Transcatheter Closure of Atrial Septal Defects with 40 mm Septal Occluder in Shahid Gangalal National Heart Centre, Nepal

Background and Aims: Transcatheter closure of Atrial septal defect (ASD) is one of important modality of treatment these days for ASD secundum. However, there is a paucity of data on transcatheter closure of ASDs with ³40 septal occluder. We aim to study the outcome of ASD device closure with ³40 mm Septal Occluder in Shahid Gangalal National Heart Centre, Nepal. Methods: It was a prospective single center study conducted at Shahid Gangalal National Heart Centre, Nepal.Among the 27 patient who underwent successful device closure with ³40 mm devices from January 2016 till December 2019, twenty-six patients could be prospectively followed up during May 2020 till December 2020. A Performa was designed to collect information about age, gender, ASD size, ASD device type and size. Right atrium(RA) and right ventricle(RV) dimension, level of tricuspid regurgitation (TR) and tricuspid regurgitation pressure gradient before the procedure and at the time of follow up were also recorded. Results: Amplatzer septal occluder (40mm) was used in 25 (96.1%) patients and Memopart device (42mm) was used in 1 (3.9%) patient. Before the procedure all patients had dilated RA and RV, Mild TR, moderate TR and severe TR was present in 14 (53.8%), 10 (38.4%) and 2 (7.7%) patients respectively. At follow up, only one (3.9%) patient had dilated RA and RV. Mean Tricuspid regurgitation pressure gradient decreased from mean 44.4 mmHg to 18.9 mmHg. Conclusion: Transcatheter Closure of Atrial Septal Defects with ³40 mm Septal Occluder is safe and effective in short term follow up.

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Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder

Cardiology in the Young ◽

10.1017/s1047951100005369 ◽

1999 ◽

Vol 9 (5) ◽

pp. 468-473 ◽

Cited By ~ 145

Author(s):

Felix Berger ◽

Peter Ewert ◽

Per G. Boöjrnstad ◽

Ingo Dähnert ◽

Gregor Krings ◽

...

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Transcatheter Closure ◽

Paradoxical Embolism ◽

Residual Shunt ◽

Septal Defects ◽

Atrial Septal Defects ◽

Diagnostic Cardiac Catheterization ◽

Long Term Follow Up

AbstractTo judge whether an Amplatzer™ Septal Occluder can be used as standard therapy instead of surgery for closure of atrial septal defects we report our experiences in 200 patients. Of these patients, 127 had an atrial septal defect with haemodynamically significant left-to-right shunt, 68 patients a persistent oval foramen after presumed paradoxical embolism, and 5 had a fenestration after Fontan-repair. Mean age was 29.8 years (0.8 to 77.7 years). Body weight ranged from 6.9 to 120.0 kg (mean 51.5 kg). After diagnostic cardiac catheterization, and balloon-sizing of the defect, we implanted Amplatzer™ Septal Occluders with stents of 4 to 28 mm diameter. Follow-up studies were obtained after 48hours, and one, six, and twelve months. Transcatheter closure of the atrial septal defect proved successful in all without any relevant residual shunts. In particular, complete closure was achieved in all patients after presumed paradoxical embolism. The mean period of follow-up is 9–5 months, with a range from 0.4 to 23.5 months, giving a total of 1898 patient months. The occlusion rate after three month was 98.1°. A trivial haemodynamically insignificant residual shunt remained in 1.9° of the patients. Fluoroscopy times ranged from 0 to 43.5 minutes, with a median of 8.7 minutes. The excellent results in the short and medium term in children and adults have resulted in using this device routinely at the present time for closure of central atrial septal defects up to a diameter of 28 mm. Final judgement, however, is only possible after long-term follow-up.

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Individualized Experience With Percutaneous Transcatheter Closure of Multiple Atrial Septal Defects: A Single-Center Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.628322 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zhenquan Wang ◽

Yi Zhan ◽

Jiahui Jin ◽

Tingting Wu ◽

Songyue Zhang ◽

...

Keyword(s):

Transcatheter Closure ◽

Atrial Septal Aneurysm ◽

Single Center ◽

Residual Shunt ◽

Closure Rate ◽

Septal Defects ◽

Atrial Septal Defects ◽

Single Center Study ◽

Center Study

Multiple atrial septal defects (ASDs) are one type of secundum ASD, most of which have an atrial septal aneurysm or long interdefect distance. In our retrospective single-center study, we reviewed different closure strategies for multiple ASDs. We analyzed 50 patients who underwent percutaneous transcatheter closure from May 2011 to July 2019. Information on the patients' characteristics, operation procedure, occluder selection, and complications was collected. According to the feature of the defects and device choice, multiple ASDs were divided into five groups. A successful operation was achieved in every patient. A total of 50 patients were implanted with 58 devices, with 26 patients implanted with a single standard ASD occluder (ASDO); six patients were implanted with double standard ASDOs, and only one patient was implanted with three standard ASDOs. There were 17 patients whose closure was made using the small-waist–big-edge ASDO. Seventy-six percent of the patients (38/50) had an immediate residual shunt. During the mean follow-up of 25.76 ± 22.53 months, the complete closure rate was 92%. Except for two patients with a transient atrioventricular block, individualized experience with percutaneous transcatheter closure for multiple ASDs was effective in a single-center study. After a mid- to long-term follow-up, the multiple ASDOs and small-waist–big-edge ASDO had no serious adverse events or complications.

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ASD device closure in elderly adults

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i3.23195 ◽

2019 ◽

Vol 10 (3) ◽

pp. 17-20

Author(s):

Chandra Mani Adhikari ◽

Sachin Dhungel ◽

Amrit Bogati ◽

Jagat Adhikari ◽

Manish Shrestha ◽

...

Keyword(s):

Elderly Patients ◽

Pressure Gradient ◽

Tricuspid Regurgitation ◽

Common Symptom ◽

Elderly Adults ◽

Device Closure ◽

Single Center Study ◽

Hemodynamic Improvement ◽

The Mean

Background: Closure of ASDs in elderly patients caused significant clinical and hemodynamic improvement after device closure. Aims and Objective: We aim to share our experience of ASD device closure in elderly adults. Materials and Methods: It was a prospective single center study done at Shahid Gangalal National Heart Centre. All elderly patients (>50years) who underwent ASD device closure fromFeb 2016 to July 2018 and completed three months of device closure were prospectively follow up for the symptoms, RA and RV dimension, Tricuspid Regurgitation and Tricuspid Regurgitation pressure gradient (TRPG). Results: During the study period 48 elderly adults underwent successful ASD device closure. Except one patient we could follow up all patients. Among the patient’s 33 were female, Age ranged from 50years to 72years with the mean age of 55 years. Shortness of breath was the most common symptom during presentation. ASD size ranged from 10mm to 33mm with the mean of 23mm. Device size ranged from 14mm to 40mm with the mean of 29mm. Amplatzer septal occluder was used in 47 patients. RA and RV were dilated in all patients. Mild TR was present in 26 patients, Moderate TR in 17 patients, Severe TR in 5 patients. Mean follow-up time was 12 months. Symptoms reduced in all patients expect one. RA and RV size reduced in all patients. Tricuspid regurgitation pressure gradient reduced from mean of 56 mmHg to Mean of 16 mmHg. During the follow up level of tricuspid regurgitation reduced, 11 patients had mild TR, Trace TR in 15 patients. Conclusion: ASD device closure can result in improvement in clinical and hemodynamic in elderly adults.

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Transcatheter Closure of Perimembranous and Intracristal Ventricular Septal Defects Using Amplatzer Duct Occluder II in Children

Journal of Interventional Cardiology ◽

10.1155/2021/4091888 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Shenrong Liu ◽

Wenqian Zhang ◽

Junjie Li ◽

Shushui Wang ◽

Mingyang Qian ◽

...

Keyword(s):

Aortic Valve ◽

Tricuspid Regurgitation ◽

Septal Defect ◽

Transcatheter Closure ◽

Amplatzer Duct Occluder ◽

Ventricular Septal Defects ◽

Septal Defects ◽

Total Range ◽

New Onset

Background. Transcatheter closure of aneurysmal perimembranous ventricular septal defect (pmVSD), pmVSD near the aortic valve, and intracristal VSD (icVSD) with symmetrical or asymmetrical ventricular septal defect occluders still presents significant challenges. We report our experience with transcatheter closure of pmVSD and icVSD using Amplatzer duct occluder II (ADO II) in children. Method. We retrospectively analyzed all children, who presented to our hospital consecutively between March 2014 and June 2020 for attempted transcatheter closure of pmVSD or icVSD with the ADO II device. Standard safety and last-follow-up outcomes were assessed and compared. Results. In total, 41 patients underwent transcatheter closure of VSD with the ADO II (28 in pmVSD and 13 in icVSD groups) with a median age of 3.5 years (total range: 0.9 to 12 years) and median weight of 15.0 kg (total range: 10.0 to 43.0 kg). Implantation was successful in 40/41 patients (97.5%, 27/28 in pmVSD group, 13/13 in icVSD group). One patient with mild aortic valve prolapse in pmVSD group developed new-onset moderate aortic regurgitation after a 4/4 mm ADO II was deployed; however, this resolved after the device was retrieved and successfully replaced with a 5 mm zero eccentric VSD occluder. There was no procedure-related mortality. After a median follow-up of six months (total range: 6 to 72 months), complete closure rates were 85.1% and 76.9% among pmVSD and icVSD groups, respectively. In the pmVSD group, one case of new-onset moderate tricuspid regurgitation was observed at six months, and there was one case of severe tricuspid regurgitation that had progressed from mild tricuspid regurgitation at 12 months. No serious complications were noted in the icVSD group. Conclusion. ADO II provides a safe and reproducible alternative for the closure of perimembranous and intracristal ventricular septal defects with a diameter less than 5 mm in young children.

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Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

10.21203/rs.2.16046/v2 ◽

2020 ◽

Author(s):

Long Wang ◽

Lin Xie ◽

Weiqiang Ruan ◽

Tao Li ◽

Changping Gan ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Close Monitoring ◽

The Novel ◽

Ventricular Septal Defects ◽

Device Closure ◽

Residual Shunt ◽

Septal Defects ◽

Perventricular Device Closure

Abstract Background: This report presents updated data and mid-term follow-up information to a former study introducing the novel technique of percutaneous-perventricular device closure of doubly committed subarterial ventricular septal defect. Methods: Thirty-eight patients were added to the former series. There were 54 patients in total who had isolated doubly committed subarterial ventricular septal defects and underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5-year follow-up. Results: Surgery was successful in 53 patients (98.1%). There was no death, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient developed pericardial effusion and tamponade in the former series. The mean hospital stay was 3.2±0.6 days (range, 3.0 to 6.0 days), and only one unsuccessful case needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be safe. Close monitoring for bleeding is essential postoperatively, especially in younger patients. This technique is generally safe with acceptable mid-term follow-up.

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Comparative effects of surgical and percutaneous repair on P-wave and atrioventricular conduction in patients with atrial septal defect – ostium secundum type

Cardiology in the Young ◽

10.1017/s1047951112000418 ◽

2012 ◽

Vol 23 (1) ◽

pp. 132-137

Author(s):

Hassan Javadzadegan ◽

Mehrnoush Toufan ◽

Ali Reza Sadighi ◽

Joyce M. Chang ◽

Nader D. Nader

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

P Wave ◽

P Value ◽

Device Closure ◽

Wave Duration ◽

Septal Defects ◽

Atrial Septal Defects ◽

P Wave Duration ◽

Pr Interval

AbstractBoth surgical and percutaneous closures of atrial septal defects have been successful in reversal of atrial dilatation. We compared the effects of surgical and percutaneous transvenous device closure of atrial septal defect on post-operative changes of P-wave duration, PR segment, and PR interval. Electrocardiographic data were prospectively collected from 30 patients following either surgical (n equal to 16) or percutaneous (n equal to 16) repair of atrial septal defects between 2004 and 2010. A cardiologist blinded to the closure technique performed the electrocardiographic analyses. P-wave duration (98.5 plus or minus 15.4 to 86.4 plus or minus 13.2 milliseconds, p-value less than 0.05) and PR interval (162.9 plus or minus 18.5 to 140.6 plus or minus 15.2 milliseconds, p-value less than 0.05) were reduced after percutaneous transvenous device closure. P-wave duration (104.5 plus or minus 24.7 versus 83.2 plus or minus 13.3 milliseconds, p-value less than 0.05) and PR interval (173.2 plus or minus 38.7 versus 144.3 plus or minus 32.0 milliseconds, p-value less than 0.05) were also reduced after surgical closure. PR segment in the percutaneous group was significantly reduced (63.4 plus or minus 14.5 to 52.1 plus or minus 10.8 milliseconds, p-value less than 0.05), but not in the surgical group (68.6 plus or minus 18.7 versus 61.1 plus or minus 24.7 milliseconds). However, the difference in PR segment changes between the two groups was not significant (−11.3 plus or minus 15.0 versus −7.6 plus or minus 20.5 milliseconds, p-value equal to 0.18). Our analysis demonstrates that the changes between the two groups were not different and that both closure techniques reduce P-wave duration, PR segment, and PR interval within 6 months.

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Transcatheter closure of secundum atrial septal defects with the atrial septal defect occlusion system (ASDOS): initial experience in children.

Heart ◽

10.1136/hrt.75.1.83 ◽

1996 ◽

Vol 75 (1) ◽

pp. 83-88 ◽

Cited By ~ 91

Author(s):

G. Hausdorf ◽

M. Schneider ◽

B. Franzbach ◽

C. Kampmann ◽

K. Kargus ◽

...

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Transcatheter Closure ◽

Initial Experience ◽

Septal Defects ◽

Atrial Septal Defects

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Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

10.21203/rs.2.16046/v3 ◽

2020 ◽

Author(s):

Long Wang ◽

Lin Xie ◽

Weiqiang Ruan ◽

Tao Li ◽

Changping Gan ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Close Monitoring ◽

The Novel ◽

Ventricular Septal Defects ◽

Device Closure ◽

Residual Shunt ◽

Septal Defects ◽

Perventricular Device Closure

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Value of transesophageal echocardiography in device closure of perimembranous ventricular septal defects in children via an ultraminimal intercostal incision

10.22541/au.163275137.78829535/v1 ◽

2021 ◽

Author(s):

Jin Yu ◽

Jing Ye ◽

Zewei Zhang ◽

Xiuzhen Yang ◽

Lianglong Ma ◽

...

Keyword(s):

Transesophageal Echocardiography ◽

Septal Defect ◽

Perioperative Period ◽

Ventricular Septal Defects ◽

Device Closure ◽

Efficacy Evaluation ◽

Puncture Site ◽

Septal Defects ◽

Perimembranous Ventricular Septal Defect

Object: Investigate the value of transesophageal echocardiography (TEE) in perimembranous ventricular septal defect (PmVSD) closure via a left parasternal ultra‐minimal trans intercostal incision in children. Methods: From January 2015 and December 2020, 212 children with PmVSD were performed device occlusion via an ultraminimal intercostal incision. TEE is used throughout the perioperative period, including TEE assessment, TEE-guided localization of the puncture site, TEE guidance. All patients were followed up using transthoracic echocardiography for over 6 months. Results: A total of 207 cases successfully occluded, the successful rate was 97. 64%. one hundred and forty-five patients had single orifice, and 62 patients had multiple orifices in the AMS. During the operation, the surgeon readjusted the device or replaced the larger device in 17 cases. After operation, there were 19 cases of slight residual shunts, 13 cases of pericardial effusion and 4 cases of pleural effusion. And all were back to normal during the 4- month follow-up period. Mild mitral regurgitation was presented in 1 patient and remained the same during the follow-up period. No other complications were found. Conclusions: TEE was used to evaluate and determine the defect in PmVSDs with an concentric occluder via a left parasternal ultra‐minimal trans intercostal incision. TEE guidance and immediate postoperative efficacy evaluation are of great value, which can effectively guide the treatment of PmVSD occlusion.

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Device Size for Transcatheter Closure of Ovoid Interatrial Septal Defect

The Heart Surgery Forum ◽

10.1532/hsf98.20121131 ◽

2013 ◽

Vol 16 (4) ◽

pp. 193

Author(s):

Eun Hyun Cho ◽

Jinyoung Song ◽

Eun Young Choi ◽

Sang Yoon Lee

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Transcatheter Closure ◽

Defect Group ◽

Amplatzer Septal Occluder ◽

Septal Defects ◽

Atrial Septal Defects ◽

The Mean ◽

Computed Tomography Image ◽

Device Size

Background: For successful transcatheter closure of an atrial septal defect with the Amplatzer septal occluder, the shape of the defect should be considered before selecting the device size. The purpose of this study was to evaluate the results of transcatheter closure of an ovoid atrial septal defect.Methods: Between January 2010 and February 2012, cardiac computer tomography examinations were performed in 78 patients who subsequently underwent transcatheter closure of an atrial septal defect. In this retrospective study, we reviewed these patients' medical records. We defined an ovoid atrial septal defect as a value of 0.75 for the ratio of the shortest diameter of the defect to the longest diameter, as measured in a computed tomography image. Transthoracic echocardiography examinations were made at 1 day and 6 months after the procedure.Results: Transcatheter closure of an atrial septal defect was successful in 26 patients in the ovoid-defect group and in 52 patients in the round-defect group. There were no serious complications in either group, and the rate of complete closure at 6 months was 92.3% in the ovoid-defect group and 93.1% in the round-defect group (P > .05). The mean (SD) difference between the device size and the defect's longest diameter, and the mean ratio of the device size to the longest diameter were significantly smaller in the ovoid-defect group (1.7 � 2.9 versus 3.8 � 2.5 and 1.1 � 0.1 versus 1.3 � 0.2, respectively).Conclusions: Transcatheter closure of an atrial septal defect is indicated even for an ovoid atrial septal defect. Ovoid atrial septal defects can be closed successfully with smaller sizes of the Amplatzer septal occluder than for round atrial septal defects.

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