scholarly journals Long-Term Follow-Up of Atrial Septal Defect Closure after Percutaneous Balloon Mitral Valvuloplasty by Transesphageal Echocardiography?

2019 ◽  
Vol 4 (1) ◽  
pp. 001-007
Author(s):  
Samir Rafla ◽  
Tarek Bishay
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Balloon Catheter ◽  
Transseptal Puncture ◽  
Mitral Valvuloplasty ◽  
Percutaneous Balloon Mitral Valvuloplasty ◽  
Percutaneous Balloon ◽  
Inoue Balloon ◽  
Asd Closure

Percutaneous Balloon Mitral Valvuloplasty (PBMV) involves atrial septostomy during the procedure. One of the consequences of transseptal puncture is the creation of an Atrial Septal Defect (ASD). Transesophageal Echocardiography (TEE) can detect Left to Right (L-R) shunts too small to be detected by other methods. The aim of this study was to evaluate the 3 years follow-up of ASD closure after PBMV by TEE. 200 consecutive patients with rheumatic Mitral Stenosis (MS) who underwent successful PBMV by using the Inoue balloon catheter were studied prospectively. ASD with small L-R atrial shunting occurred in all the patients (100%) immediately after PBMV. Total study 200 patients. All the ASDs were small in size (≤ 5 mm). The puncture site (ASD site) occurred in the fossa ovalis (Fo.Ov) in 120 patients (60%), while it occurred outside the Fo.Ov (either in the superior limbus or in the inferior limbus of the Interatrial Septum (IAS)) in the other 80 patients (40%). 180 patients presented at 6 month follow-up. ASD was closed in 117 patients (65%), while it was persisted in 63 patients (35%). 95 patients presented at 3 years follow-up. ASD was closed in 76 patients (80%) (Group I), while it was persisted in 19 patients (20%) (Group II). All the 74 patients who had ASD immediately after PBMV in the Fo.Ov, presented with ASD closure at 3 years follow-up. Only 2 patients who had ASD immediately after PBMV outside the Fo.Ov, presented with ASD closure at 3 years follow-up. All the 19 patients who presented at 3 years follow-up with ASD persistence had ASD immediately after PBMV outside the Fo.Ov (14 in the superior limbus and 5 in the inferior limbus). No patient presented at 3 years follow-up with ASD persistence, had ASD immediately after PBMV in the Fo.Ov Large LAD, high total Echocardiographic (echo) score of the Mitral Valve (MV), thick Fo.Ov, thick superior limbus, thick inferior limbus and ASD site immediately after PBMV outside the Fo.Ov were significant predictors of ASD persistence at 3 years follow-up. In conclusion, ASD with L-R atrial shunting occurs in all the patients after PBMV by using the Inoue balloon catheter. ASD after PBMV persists in 20% of the patients at 3 years follow-up. Predictors of ASD persistence at 3 years follow-up are: large LAD, high total echo score of the MV, thick Fo.Ov, thick superior limbus, thick inferior limbus and ASD site immediately after PBMV outside the Fo.Ov. ASD closes at 3 years follow-up in all the patients who had ASD in the Fo.Ov immediately after PBMV. All the patients with ASD persistence at 3 years follow-up had ASD outside the Fo.Ov after PBMV. It is recommended that operators doing transseptal puncture during PBMV by using the Inoue balloon catheter should aim to do it in the Fo.Ov.

Surgical Strategy in Patients with Atrial Septal Defect and Severe Pulmonary Hypertension

2012 ◽  
Vol 15 (2) ◽  
pp. 111 ◽  
Author(s):  
Yang Hyun Cho ◽  
Tae-Gook Jun ◽  
Ji-Hyuk Yang ◽  
Pyo Won Park ◽  
June Huh ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Maze Procedure ◽  
Severe Pulmonary Hypertension ◽  
Tricuspid Annuloplasty ◽  
Pulmonary Arterial ◽  
Asd Closure

The aim of the study was to review our experience with atrial septal defect (ASD) closure with a fenestrated patch in patients with severe pulmonary hypertension. Between July 2004 and February 2009, 16 patients with isolated ASD underwent closure with a fenestrated patch. All patients had a secundum type ASD and severe pulmonary hypertension. Patients ranged in age from 6 to 57 years (mean � SD, 34.9 � 13.5 years). The follow-up period was 9 to 59 months (mean, 34.5 � 13.1 months). The ranges of preoperative systolic and pulmonary arterial pressures were 63 to 119 mm Hg (mean, 83.8 � 13.9 mm Hg) and 37 to 77 mm Hg (mean, 51.1 � 10.1 mm Hg). The ranges of preoperative values for the ratio of the pulmonary flow to the systemic flow and for pulmonary arterial resistance were 1.1 to 2.7 (mean, 1.95 � 0.5) and 3.9 to 16.7 Wood units (mean, 9.8 � 2.9 Wood units), respectively. There was no early or late mortality. Tricuspid annuloplasty was performed in 14 patients (87.5%). The peak tricuspid regurgitation gradient and the ratio of the systolic pulmonary artery pressure to the systemic arterial pressure were decreased in all patients. The New York Heart Association class and the grade of tricuspid regurgitation were improved in 13 patients (81.2%) and 15 patients (93.7%), respectively. ASD closure in patients with severe pulmonary hypertension can be performed safely if we create fenestration. Tricuspid annuloplasty and a Cox maze procedure may improve the clinical result. Close observation and follow-up will be needed to validate the long-term benefits.

scholarly journals Cryoballoon Atrial Fibrillation Ablation in a Patient with an Atrial Septal Defect Closure Device

2021 ◽  
Author(s):  
Meisam Mokhtari ◽  
Zahra Khajali ◽  
Mona Heidarali ◽  
Majid Haghjoo
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Septal Defect ◽  
Closure Device ◽  
Atrial Septal Defect Closure ◽  
Occluder Device ◽  
Asd Closure

Atrial fibrillation (AF) is the most commonly treated arrhythmia in clinical practice and is often found in association with an atrial septal defect (ASD). However, ASD closure rarely confers complete arrhythmia control. A 23-year-old man presented to our center with frequent episodes of palpitations. AF was documented in 12-lead electrocardiography, and echocardiography showed a secundum-type ASD, 14 mm in size, with a significant left-to-right shunt. ASD closure was performed successfully with an ASD occluder device with no residual shunting. During follow-up, the patient experienced several episodes of AF. Thirteen months after the ASD closure, cryoballoon pulmonary vein isolation was done successfully with no complications. During a 12-month follow-up, he had no symptoms or AF recurrences, and echocardiography showed no residual shunting. This study showed that cryoballoon pulmonary vein isolation could be performed successfully without residual shunts in patients with ASD closure devices.

scholarly journals Very Long Term Follow-Up After Percutaneous Balloon Mitral Valvuloplasty

2018 ◽  
Vol 11 (19) ◽  
pp. 1945-1952 ◽  
Author(s):  
Rafael A. Meneguz-Moreno ◽  
J. Ribamar Costa ◽  
Nisia L. Gomes ◽  
Sergio L.N. Braga ◽  
Auristela I.O. Ramos ◽  
...  
Keyword(s):  
Mitral Valvuloplasty ◽  
Percutaneous Balloon Mitral Valvuloplasty ◽  
Percutaneous Balloon ◽  
Long Term Follow Up

scholarly journals Trans-catheter Treatment of Lutembacher Syndrome -A Case Report

2015 ◽  
Vol 7 (2) ◽  
pp. 162-165
Author(s):  
ABM Abdus Salam ◽  
SK Ziarat Islam ◽  
Kazi Abul Hasan ◽  
Saiful Islam Azad ◽  
Ataul Haque ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiopulmonary Bypass ◽  
Atrial Septal Defect ◽  
Potential Risk ◽  
Septal Defect ◽  
Surgical Repair ◽  
Device Closure ◽  
Mitral Valvuloplasty ◽  
Inoue Balloon ◽  
Methods Of Treatment

Lutembacher syndrome is a rare combination of congenital Atrial Septal Defect (ASD) and acquired Rheumatic Mitral Stenosis (MS).It is usually treated by surgical repair with potential risk of cardiopulmonary bypass. With the advancement of interventional methods of treatment it is amenable to nonsurgical transcatheter management. We are reporting a case of Lutembacher syndrome that was successfully treated with percutaneouos Inoue balloon mitral valvuloplasty and device closure of atrial septal defect. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22267 Cardiovasc. j. 2015; 7(2): 162-165

P4166Efficacy and safety of novel biodegradable device for closure of atrial septal defect: from preclinical study to first-in-man experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y F Li ◽  
Y M Xie ◽  
Z F Xie ◽  
S S Wang ◽  
B N Li ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Preclinical Study ◽  
Closure Device ◽  
Swine Model ◽  
Procedure Time ◽  
Short Term ◽  
The Mean ◽  
Asd Closure

Abstract Background closure of atrial septal defect (ASD) has emerged as the treatment of choice for the majority of defect. The biodegradable ASD closure device is a novel, absorbable device made of poly-L_latic acid (PLLA). This study evaluates the feasibility, safety and effectiveness of PLLA biodegradable ASD closure device in a swine model and for the first time in human. Objective The study reports on the 24- and 36- month follow-up results of PLLA device implanted in a swine model and the first-in- man experience with 6-month follow-up. Method Preclinical study was done in a swine ASD model. In a clinical setting, 5 pediatric patients with a secundum ASD who a clinically left-to-right shunt were enrolled in our center. Percutaneous ASD closure procedure with PLLA device was performed with fluoroscopic and transcatheter echocardiography (TTE) guidance. Procedure results and clinical outcomes at 1 day, 30 days, 3 months and 6 months after closure procedure were analyzed. Results 24- and 36-month follow-up results of preclinical study demonstrated that the PLLA device exhibited good endothelialization and degradability in a swine model. In clinical study, device implantation was successfully achieved in all of 5 patients (median age, 3.6 years; range, 3.1–6.5 years). The mean ASD size was (13.4±2.4)mm (range, 10–16mm). The mean pulmonary-to-systemic blood flow ratio (Qp:Qs) was (1.7±0.2):1 with a range of 1.5:1 to 2.0:1. The mean procedure time and the mean fluoroscopy time were (36.2±11.3) and (6.4±1.0)minutes, respectively. There was no evidence of short-term complications related to the device or the delivery system. No device dislodgement, significant aortic valve or mitral valve regurgitation, new onset cardiac arrhythmia, or other adverse events were reported. Characteristics and procedure data of the 5 patients who underwent ASD closure procedure with PLLA device Patient No. Age Weight Gender Defect size Qp:Qs Mean Pulmonary Pressure Device size (mm) Sheath (Fr) Procedure time Fluoroscopy time Immediate residual shunt (years) (kg) (mm) (mmHg) (mm) (Fr) (min) (min) 1 4.9 23.5 Male 17 1.7:1 22 24 12 52 7.6 None 2 3.1 10.0 Male 14 2.0:1 19 20 12 26 5.4 None 3 6.5 21.0 Male 15 1.8:1 22 20 12 31 6.0 None 4 3.2 14.5 Female 12 1.5:1 13 18 10 44 7.3 None 5 3.6 12.5 Male 10 1.5:1 17 14 10 28 5.5 None Conclusion This study is the first to demonstrate the feasibility, safety and effectiveness of PLLA biodegradable device in human, with no evidence of short-term complications and a high rate of early shunt closure. Acknowledgement/Funding National Key R&D Program of China (Grant Number: 2016 YFC1100305)

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