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...

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 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 simultaneous transcatheter treatment for secundum atrial septal defect with valvular pulmonary stenosis in children under transthoracic echocardiography guidance

2021 ◽  
Author(s):  
Xuning Lu ◽  
Ping Wen ◽  
Yuhang Liu ◽  
Quanwei Zhu
Keyword(s):  
Atrial Septal Defect ◽  
Transthoracic Echocardiography ◽  
Septal Defect ◽  
Pulmonary Stenosis ◽  
Secundum Atrial Septal Defect ◽  
Device Closure ◽  
The Mean ◽  
Valvular Pulmonary Stenosis ◽  
Transcatheter Device

Abstract BACKGROUND Transcatheter device closure of secundum atrial septal defect (ASD) with valvular pulmonary stenosis (PS) under fluoroscopy and/or transesophageal echocardiography (TEE) guidance is a mature technology. However, little study has focused on whether the technology can be guided totally by transthoracic echocardiography (TTE), even in children.METHODS Thirteen children with ASD combined with PS underwent transcatheter device closure totally guided by TTE at our cardiac center from March 2 016 to August 2 019. Percutaneous transcatheter pulmonary valvuloplasty was performed first and then transcatheter closure of the ASD uneventfully.RESULTS All cases were successfully treated with transcatheter balloon pulmonary valvuloplasty and closure of ASD respectively via femoral vein approach solely under TTE guidance. The mean defect size was 8.1±1.4 mm (range: 5.5-10 mm), the preoperative mean pressure gradient across pulmonary valve was 61.2±5.5 mmHg (range: 51-71 mmHg). The mean device size used was 11.1±1.9 mm (range: 8- 14 mm), the mean procedure time was 55.1±8.0 min (range: 45-71 min). There were no serious cardiovascular related complications. During the follow-up period (10 mon to 47mon), no arrhythmias device, thrombosis, residual fistulas or device frame fractures were detected. PS gradient had significant difference before and after procedure during the follow up (t=28.9, P =0.000).CONCLUSION Simultaneous transcatheter treatment for ASD complicated by PS in children under TTE guidance is an safe and effective therapeutic option.

scholarly journals GW25-e1595 Clinical applications of echocardiography in transcatheter device closure of atrial septal defect

2014 ◽  
Vol 64 (16) ◽  
pp. C193
Author(s):  
Cheng Yingzhang ◽  
Wang Gan ◽  
Li Yunde ◽  
Liu Yanna ◽  
Wu Qinghua ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Clinical Applications ◽  
Device Closure ◽  
Transcatheter Device

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.

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