scholarly journals Changes of Cardiac Rhythm after Closure of Secundum Atrial Septal Defect in Children

2020 ◽  
pp. 84-96
Author(s):  
Esraa A. Sorour ◽  
Elatafy E. Elatafy ◽  
Wael N. Lotfy ◽  
Amr M. Zoair
Keyword(s):  
Risk Factors ◽  
Atrial Septal Defect ◽  
Pediatric Patients ◽  
Septal Defect ◽  
Hemodynamic Instability ◽  
Right Atrial ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

Background: Arrhythmias may complicate congenital heart diseases, such as secundum atrial septal defects. We aimed at following up the rhythm changes in children after closure of ostiumsecundum atrial septal defects. Methods: The current study was conducted in the Pediatric Cardiology Unit, Tanta University, on 60 pediatric patients who had undergone either trans-catheter or surgical closure of secundum atrial septal defects. Complete history taking and full clinical assessment were done. Echocardiographic assessment was performed to detect any residual defects, and assess chamber dimensions, and cardiac functions. Electrocardiographic assessment including Holter monitoring was performed within two months after the procedure, after six months, and after one year. Arrhythmias were classified into major and minor types. All results were statistically analyzed and tabulated. Results: There were no significant differences between the pre-closure rhythm and the rhythm after closure of the defects throughout the follow-up. The percentage of patients with major arrhythmias has increased from 6.7% of the total sample to 13.3%, 11.6%, and 11.6% in the early, midterm and late follow up respectively. The significant risk factors for postoperative arrhythmias were; pre-closure arrhythmia, right atrial dilatation, and serious hemodynamic instability in the early follow up. Conclusions: We concluded that arrhythmias were common before and after atrial septal defect closure, without significant differences. Pre-closure arrhythmia, right atrial dilatation, and serious hemodynamic instability are considered important risk factors of arrhythmias after secundum atrial septal defect’s closure in pediatric patients.

scholarly journals Risk factors for adverse events within one year after atrial septal closure in children: a retrospective follow-up study

2019 ◽  
Vol 30 (3) ◽  
pp. 303-312 ◽  
Author(s):  
Gustaf Tanghöj ◽  
Petru Liuba ◽  
Gunnar Sjöberg ◽  
Estelle Naumburg
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Conditional Logistic Regression ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Increased Risk ◽  
One Year

AbstractIntroduction:Secundum atrial septal defect is one of the most common congenital heart defects. Previous paediatric studies have mainly addressed echocardiographic and few clinical factors among children associated with adverse events. The aim of this study was to identify neonatal and other clinical risk factors associated with adverse events up to one year after closure of atrial septal defect.Methods:This retrospective case–control study includes children born in Sweden between 2000 and 2014 that were treated surgically or percutaneously for an atrial septal defect. Conditional logistic regression was used to evaluate the association between major and minor adverse events and potential risk factors, adjusting for confounding factors including prematurity, neonatal sepsis, neonatal general ventilatory support, symptomatic atrial septal defects, and pulmonary hypertension.Results:Overall, 396 children with 400 atrial septal defect closures were included. The median body weight at closure was 14.5 (3.5–110) kg, and the median age was 3.0 (0.1–17.8) years. Overall, 110 minor adverse events and 68 major events were recorded in 87 and 49 children, respectively. Only symptomatic atrial septal defects were associated with both minor (odds ratio (OR) = 2.18, confidence interval (CI) 95% 1.05–8.06) and major (OR = 2.80 CI 95% 1.23–6.37) adverse events.Conclusion:There was no association between the investigated neonatal comorbidities and major or minor events after atrial septal defect closure. Patients with symptomatic atrial septal defects had a two to four times increased risk of having a major event, suggesting careful management and follow-up of these children prior to and after closure.

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.

Persistent electrical and morphological atrial abnormalities after early closure of atrial septal defect

2004 ◽  
Vol 14 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Clifford L. Cua ◽  
Elizabeth E. Sparks ◽  
David P. Chan ◽  
Curt J. Daniels
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Pearson Correlation ◽  
P Wave ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Pr Interval ◽  
Early Closure ◽  
The Right

Atrial arrhythmias are associated with enlarged atrial chambers and an increased duration of the P wave. Repair of atrial defects within the oval fossa is expected to normalize atrial size. Few studies, however, have evaluated electrical and morphological atrial features after repair. Our study was performed to determine if atrial abnormalities exist after surgical closure of such atrial septal defects, and whether early closure improves outcome. We recruited patients who had undergone surgical closure of a defect within the oval fossa, so-called “secundum” atrial septal defects. Electrocardiograms, signal averaged electrocardiograms, and echocardiograms were performed. Two-tailed test and Pearson correlation was utilized for statistical analysis. The population consisted of 20 patients and 27 controls, with the mean age of the patient being 11.25 ± 5.10 years, their age at surgery 6.55 ± 5.10 years, and the time since surgery 4.70 ± 2.61 years. The size of the right (23.88 ± 6.35 ml/m2 versus 18.84 ± 4.43 ml/m2) and left (21.91 ± 12.47 ml/m2 versus 17.72 ± 4.83 ml/m2) atrium were significantly larger in the patients. The duration of the P wave (108 ± 16 ms versus 96 ± 8 ms) and the duration of the PR interval (155 ± 18 ms versus 138 ± 23 ms) were longer. No correlation existed between age or interval since surgery with atrial sizes or measurements of the signal averaged electrocardiogram. We conclude that, despite surgical repair, abnormalities exist in patients with an atrial septal defect. Early surgery does not appear to prevent the atrial abnormalities.

Atrial septal defect

ESC CardioMed ◽  
2018 ◽  
pp. 790-793
Author(s):  
Robert Yates ◽  
Marc Gewillig
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Atrial Arrhythmias ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Long Term Follow Up ◽  
Early Closure ◽  
Symptomatic Benefit

Secundum atrial septal defects are usually well tolerated in childhood but may cause significant symptoms in adults. Early closure is therefore recommended and can be achieved by catheter in the majority. Symptomatic benefit is noted at any age, but long-term follow-up is required as closure in adulthood does not prevent atrial arrhythmias.

Infective endocarditis on an occluder closing an atrial septal defect

1999 ◽  
Vol 9 (1) ◽  
pp. 65-67 ◽  
Author(s):  
A. M. Bullock ◽  
S. Menahem ◽  
J. L. Wilkinson
Keyword(s):  
Infective Endocarditis ◽  
Atrial Septal Defect ◽  
Antibiotic Prophylaxis ◽  
Potential Risk ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
First Case

AbstractClosure of atrial septal defects be means of intravenous catheterisation has been undertaken using a variety of devices as an alternative to surgical closure.1–5 We describe the first case, to the best of our knowledge, of infective endocarditis complicating a successful transcatheter closure. This highlights the potential risk of this procedure, and emphasises the need for appropriate antibiotic prophylaxis until complete endothelialization of the device has occurred.

scholarly journals Outcome of Surgical Closure of Atrial Septal Defect in Sulaimani City

2020 ◽  
Author(s):  
Aso Faeq Salih ◽  
Hakam Marwan Mhadi ◽  
Shkar Raeof
Keyword(s):  
Atrial Septal Defect ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Age Group ◽  
Open Heart ◽  
Group 13 ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

An atrial septal defect (ASD), sometimes called a hole in the heart is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). To determine the outcome of surgical closure in patients with atrial septal defects, we designed a retrospective study, including 120 patients present with an atrial septal defect after surgical closure done in the cardiac teaching center in Sulaimani city. The data collected include the patients that admitted which are known cases of ASD and treated by open heart surgery during the last nine years from 1st of January 2008 until the 1st of January 2018. A total of 120 children diagnosed with Atrial Septal Defect (ASD) were included in this study with a mean age of 7.8±4.4 years; 32.5% of them were 1-5 years old, 50.8% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. Only three ASD children received medical treatment while all of them were treated surgically with open-heart surgery. The mean age of ASD children at surgery was7.8±4.4 years; 5.8% of them were 1-2 years old, 28.4% of them were 3-5 years old, 49.1% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. There was a significant association between primum ASD type and large ASD with posteroinferior deficient rims (P=0.04). A significant association was observed between primum ASD type and large IAS (P=0.006). Mean ASD diameter was significantly higher among patients with primum ASD type (P=0.01). The outcome of surgical closure of the atrial septal defect in children is effective and safe. Ventricular arrhythmia in the form of ectopic was the postoperative complication in one patient. The main echocardiography findings of children with atrial septal defects were large ASD with posteroinferior deficient rims.

Abstract 2130: Long-term Outcomes of Adult Atrial Septal Defect With Severe Pulmonary Hypertension After Surgical Closure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jeong-Hoon Kim ◽  
Duk-Hyun Kang ◽  
Jong-Young Lee ◽  
Jong-Min Song ◽  
Tae-Jin Yun ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Survival Rates ◽  
Severe Pulmonary Hypertension ◽  
Term Survival ◽  
Surgical Closure

The benefits of surgical closure has been unclear in adult atrial septal defect (ASD) with severe pulmonary hypertension (PHT), and we tried to evaluate improvement of PHT and long-term survival after surgical closure compared to medical follow-up. Methods: From 1996 to 2006, we included a total of 71 adult ASD patients (age; 43±15 years) with severe PHT documented by echocardiography. The inclusion criteria were defined as ASD diameter > 15 mm, enlarged right ventricle, and the baseline peak velocity of tricuspid regurgitation (TR) ≥ 4.0 m/sec. We excluded 5 patients with Eisenmenger syndrome documented by cardiac catheterization. Surgical closure was performed on 55 patients (OP group) and the remaining 16 patients were followed up medically (MED group). The improvement of PHT was defined as TR velocity ≤ 3.5 m/sec on follow-up echo. Results: Baseline characteristics and clinical results were compared between the two groups in table . There were no significant differences in terms of gender, ASD diameter, cardiac rhythm, and TR velocity, but the MED group was significantly older. During follow-up of 46±33 months, there were 5 deaths in the MED group and no operative or late death in the OP group, and the 5-year actuarial survival rate of the OP group was significantly higher than the MED group (58±15%, p<0.05). On subgroup analysis according to age, the OP group showed significantly better survival rates than the MED group (p<0.05) in elderly patients (age > 50). In the OP group, TR velocity was significantly decreased from 4.5±0.4 to 3.0±0.7 m/sec on follow-up echo, and improvement of PHT was observed in 47 (85%) patients. On multivariate analysis, female gender and lower baseline TR velocity were the significant independent predictors of improved PHT after surgery. Conclusions: In adult ASD with severe PHT, surgical closure can be safely performed and improve PHT effectively. Especially in elderly patients, ASD closure is significantly related with the better survival rates.

scholarly journals The role of three-dimensional transesophageal echocardiography in preoperative assessment of atrial septal defects

2015 ◽  
Vol 18 (1) ◽  
pp. 58 ◽  
Author(s):  
D. G. Tarasov ◽  
I. V. Tkachev ◽  
S. S. Kadrabulatova
Keyword(s):  
Atrial Septal Defect ◽  
Transesophageal Echocardiography ◽  
Septal Defect ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Maximum Diameter ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

An atrial septal defect is the most common congenital heart disease. Transcatheter defect closure has become widespread in recent times and the requirements for this procedure are rather strict. Two-dimensional echocardiography is limited in evaluating atrial septal defects because it provides planar images only. In order to preoperatively assess atrial septal defects, we applied three-dimensional transesophageal echocardiography and then compared the results with those of surgical operations. The maximum diameter, shape, area and localization of the atrial septal defect in 26 patients were estimated with three-dimensional echocardiography. It was found out that positive correlation existed between three-dimensional echocardiography findings and those measured during surgery. Three-dimensional echocardiography provides invaluable assistance in preoperative evaluation of atrial septal defects and in selection of treatment.

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