scholarly journals Early results of total endoscopic closure for atrial septal defect in children at Cardiovascular Center, E Hospital, Hanoi, Viet Nam

2021 ◽  
Vol 33 ◽  
pp. 16-19
Author(s):  
Nguyen Ba Phong ◽  
Do Anh Tien ◽  
Le Ngoc Minh ◽  
Tran Thuy Nguyen ◽  
Luu Phuong Linh ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Peripheral Circulation ◽  
Residual Shunt ◽  
Direct Closure ◽  
Endoscopic Closure ◽  
Early Results ◽  
Cardiovascular Center ◽  
Patch Closure ◽  
Asd Closure

Introduction: Atrial Septal Defect is the most common congenital heart disease. Minimally invasive cardiac surgery is being perfomed routinely at several cardiovascular centers in Vietnam. At E Cardiovascular Center, from 2016 to 2019, we performed total endoscopic closure for atrial septal defect in children using 4 trocars. From 2020 to present, we have reduced the number of trocars to three. This report was to evaluate the effectiveness and early results of total endoscopic closure with 3 trocars for atrial septal defect in children. Method: Twelve children underwent ASD closure from 1/2020 to 5/2021, with mean age of 7.7 years old (range from 2.5 to 11); mean weight was 20.8 kilograms (range from 12 to 40). All the patients underwent the operation with peripheral cardiopulmonary bypass (CPB). Result: The mean peripheral circulation time was 70 minutes (range from 56 to100 minutes) on beating hearts. There were 8 cases with patch-closure and 4 cases with direct-closure. After operations, we reexamined by echocardiography, the atrial septal defects were closed completely with no residual shunt, the common femoral arteries at the cannula position were normal and no stenosis were present. Conclusion: Totally endoscopic closure for ASD on beating hearts with 3 trocars is save with a very good short-term results.

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

Mechanophysiologically active patch for closure of atrial septal defect

2020 ◽  
Vol 13 (12) ◽  
pp. e237785
Author(s):  
Raja Lahiri ◽  
Namrata Gaur
Keyword(s):  
Septal Defect ◽  
Developed Countries ◽  
Right Atrial ◽  
Device Closure ◽  
Atrial Wall ◽  
Direct Closure ◽  
Surgical Closure ◽  
Septal Defects ◽  
Patch Closure ◽  
Asd Closure

Closure of atrial septal defects (ASDs) can be achieved by various methods right from direct closure to patch closure using various materials viz. pericardium, Dacron and Teflon, to device closure using percutaneous techniques. Although percutaneous techniques are the most commonly practised method in developed countries, a subset of patients will require surgical closure. Various patch materials have been used for long, but all of them have some complications and risks associated with them. We report a case of novel technique of ASD closure done using a pedicled, vascularised and contractile right atrial wall flap.

scholarly journals Simultaneous Percutaneous Coronary Intervention and Endovascular Closure of Atrial Septal Defect in Adults

Kardiologiia ◽  
2019 ◽  
Vol 59 (2) ◽  
pp. 56-60
Author(s):  
D. G. Ioseliani ◽  
I. A. Kovalchuk ◽  
T. R. Rafaeli ◽  
A. N. Rogatova ◽  
A. V. Stepanov ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Endovascular Procedures ◽  
Septal Defect ◽  
Coronary Stenting ◽  
Right Atrial ◽  
Good Effect ◽  
Syntax Score ◽  
Residual Shunt ◽  
Number Of Patients ◽  
Asd Closure

Aim:to assess clinical efficacy and expediency (appropriateness) of simultaneous single stage combined coronary stenting and closure of atrial septal defect.Materials and methods.Of total number of patients who underwent endovascular correction of atrial septal defect (ASD) (n=91), in 6 (6.6 %) the procedure of endovascular repair of secondary ASD was combined with performed at same session oronary stenting. Mean age of these patients was 63±6.4 years. Mean diameter of ASD according to transesophageal echocardiography was 13.7±3.1 мм (from 10 to 17 mm). Two patients had dysplasia of atrial septum with pronounced aneurysmal protrusion in the right atrial cavity. Estimate of coronary arteries (CA) involvement SYNTAX score was 14.5±4.9.Results.At initial stage we performed coronary stenting, then ASD closure with occluder. Technical success of combined endovascular procedures was 100 %. Six ASD occluders were implanted in 6 patients. Mean occluder diameter was 21±7,3 mm. Immediately after occluder implantation complete defect closure was achieved in 5 cases, in one case small residual shunt was observed. CA stenting procedure, in one patient after successful recanalization of chronic CA occlusion, in all cases was fulfilled without complications. At control examination after 13.5±1.5 months complete closure of defects was preserved. In all cases significant reduction of right heart chambers occurred. According to echocardiography right atrial volume decreased from 48.6±5.6 to 32.6±3.3 cm3, right ventricular volume – from 45.2±5.1 to 33.4±3.8 cm3, systolic pulmonary pressure fell from 49.7±8.6 to 32.6±6.9 mm Hg. According to control coronary angiography good effect of endovascular procedures was preserved. Tolerance to exercise rose from 68.5±11.8 до 85.3±12.4 W.Conclusion.Same time CA stenting and endovascular ASD closure appears to be safe and effective procedure. The strategy used was not associated with additive risk for a patient and shortened duration of hospital stay.

Closure of Isolated Secundum Atrial Septal Defects in Infancy

2000 ◽  
Vol 8 (1) ◽  
pp. 38-40 ◽  
Author(s):  
Raju S Iyer ◽  
Andreas Hoschtitzky ◽  
Jefferey Jacobs ◽  
Martin Elliott ◽  
Marc de Leval ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Vascular Disease ◽  
Septal Defect ◽  
Failure To Thrive ◽  
Neuromuscular Disorder ◽  
Systemic Arterial Pressure ◽  
Pulmonary Vascular Disease ◽  
Direct Closure ◽  
Patch Closure ◽  
Pulmonary Arterial

Between 1965 and 1995, 552 patients underwent closure of isolated secundum atrial septal defect, of whom 24 (4.3%) were infants with a mean age of 238.5 ± 13.8 days (range, 90 to 348 days). Mean weight was 6 ± 0.3 kg (range, 3.5 to 9 kg). Twenty-two had noted failure to thrive and 13 had chest infections. Direct closure was carried out in 20 and 4 underwent patch closure. There were 3 (12.5%) early deaths (intraoperatively, 5 hours, and 2 days postoperatively). Three patients had pulmonary hypertension with pulmonary arterial to systemic arterial pressure ratios of 0.74 to 0.83 preoperatively. Of 21 survivors, 13 were extubated within 24 hours and 8 within 72 hours of surgery. Mean hospital stay was 16.2 ± 8.2 days. There were 2 late deaths; one from pneumonia at 177 days postoperatively and another patient with a severe neuromuscular disorder who could not be extubated, died 328 days postoperatively. We concluded that some infants require early surgery and an atrial septal defect can be closed safely in infancy but the risk increases in patients with pulmonary vascular disease. The etiology of pulmonary vascular disease in such patients remains unclear.

Acute Changes in Left Ventricular End Diastolic Pressure following the Transcatheter Closure of an Atrial Septal Defect in Adults

2016 ◽  
Vol 19 (3) ◽  
pp. 145 ◽  
Author(s):  
Young Hwa Kong ◽  
Jinyoung Song ◽  
Kyung Hee Kim ◽  
June Huh ◽  
I-Seok Kang
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Device Closure ◽  
Acute Changes ◽  
Asd Closure

<strong>Background:</strong> Acute changes in left ventricular diastolic function shortly after ASD closure in elderly patients have not been well known. We aimed to investigate acute changes in left ventricular end diastolic pressure (LVEDP) in elderly patients following transcatheter closure of atrial septal defect (ASD). <br /><strong>Methods:</strong> All 19 adults with ASDs who underwent transcatheter closure between June 2013 and December 2014 were enrolled. LVEDP was measured prior to device closure and compared with that immediately following device closure and 15 minutes after device closure. <br /><strong>Results:</strong> The median age of the patients was 48 years old. The baseline E/e’ and LVEDP values were 8.3 ± 2.8 and 13 ± 3 mmHg. The LVEDP value immediately following closure was 19 ± 4 mmHg, and 15 minutes after closure was 16 ± 4 mmHg. The median increase in the LVEDP value immediately following closure was 6 mmHg, which significantly differed from that prior to closure. The LVEDP 15 minutes after closure decreased but remained significantly higher than the value observed immediately after closure. No significant changes were observed with regard to E/e’ at either 1 day or 3 months following closure. The LVEDP value <br />15 minutes after device closure was significantly correlated with those observed before closure and immediately following closure; however, no significant correlations were observed with regard to patient age, Qp/Qs, E/e’ before closure, or E/e’ 3 months after device closure.<br /><strong>Conclusion:</strong> LVEDP in adults with ASDs significantly increases following device closure. LVEDP before closure predicts LVEDP following device closure.

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.

Off-Pump Atrial Septal Defect Closure Using the Universal Cardiac Introducer®

2009 ◽  
Vol 4 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Gerard M. Guiraudon ◽  
Douglas L. Jones ◽  
Daniel Bainbridge ◽  
John T. Moore ◽  
Chris Wedlake ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Image Guidance ◽  
Septal Defect ◽  
Tracking System ◽  
Doppler Imaging ◽  
Atrial Septal Defect Closure ◽  
Off Pump ◽  
Stapling Device ◽  
Future Design ◽  
Asd Closure

Objective Optimal atrial septal defect (ASD) closure should combine off-pump techniques with the effectiveness and versatility of open-heart techniques. We report our experience with off-pump ASD closure using the Universal Cardiac Introducer (UCI) in a porcine model. The goal was to create an ASD over the fossa ovale (FO) and position a patch over the ASD under ultrasound (US) imaging and augmented virtual reality guidance. Methods An US probe (tracked with a magnetic tracking system) was positioned into the esophagus (transesophageal echocardiographic probe) for real-time image-guidance. The right atrium (RA) of six pigs was exposed via a right lateral thoracotomy or medial sternotomy. The UCI was attached to the RA wall. A punching tool was introduced via the UCI, navigated and positioned, under US guidance, to create an ASD into the FO. A patch with its holder and a stapling device were introduced into the RA via the UCI. The patch was positioned on the ASD. Occlusion of the ASD was determined using US and Doppler imaging. Results The FO membrane was excised successfully in all animals. US image-guidance provided excellent visualization. The patch was positioned in all cases with complete occlusion of the ASD. The stapling device proved too bulky, impeding circumferential positioning. Conclusions Using the UCI, ASD closure was safe and feasible. US imaging, combined with virtual and augmented reality provided accurate navigating and positioning. This study also provided valuable information on the future design of anchoring devices for intracardiac procedures.

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.

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

1999 ◽  
Vol 9 (5) ◽  
pp. 468-473 ◽  
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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