Atrial Fibrillation and Atrial Septal Defect

Blake, George E; Lakkireddy, Dhanunjaya

doi:10.4022/jafib.v1i1.390

Cited by 10 publications

(7 citation statements)

References 34 publications

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“…If the pressure increases by 5 mmHg after the occlusion, the device requires fenestration and continuation of heart failure medication. High-risk candidates with elevated LVEDP require a fenestrated occluder [8,[10][11][12]. The partial closure of the ASD with more than a 1:5 shunt helps ward off adverse cardiac and pulmonary vascular remodeling.…”

Section: Discussionmentioning

confidence: 99%

“…In patients older than 60, the risk of pulmonary edema increases to 23.6% [ 10 ]. However, closure of the atrial communication typically improves the right ventricular function and filling pressure, leading to improved left ventricular compliance and diastolic function due to ventricular interdependence [ 11 ]. To assess latent left ventricular diastolic dysfunction, a baseline evaluation of the LVEDP during the catheterization can be performed, followed by occlusion of the ASD by an appropriate balloon or with the device for 15 minutes [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Fenestration: Integrating Wings Into the Atrial Septal Occluder for Navigating a Challenging Terrain

Singh,

Mohapatra,

Kumar

et al. 2023

Cureus

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BackgroundAtrial septal defect (ASD) closure with significant left-to-right shunt and concurrent comorbidities poses challenges for intervention. A fenestrated atrial septal defect (FASD) device is a viable option for patients who cannot undergo complete occlusion due to hemodynamic and medical reasons. This study explores the use of FASD occluders in patients with secundum ASD and associated comorbidities where complete occlusion is difficult. MethodologyThis retrospective study collected the details of patients recommended for FASD closure diagnosed with significant secundum ASD and who had additional comorbidities between July 2015 and July 2023 in a tertiary cardiac center in eastern India. Among this cohort, patients who underwent FASD device placement were subjected to a comprehensive analysis. ResultsIn total, 16 patients diagnosed with secundum ASD, characterized by significant left-to-right shunt and concurrent comorbidities, were considered for FASD closure during the study period. Ultimately, 13 patients (first group) underwent fenestrated atrial septal occluder implantation. The average age was 45.07 years, with the majority being females (n = 9). Comorbidities among this cohort included substantial left ventricular diastolic dysfunction (n = 7), left ventricular diastolic dysfunction coupled with moderate pulmonary hypertension (n = 1), severe pulmonary hypertension (n = 1), severe pulmonary valvular stenosis with right ventricular diastolic dysfunction (n = 2), and systemic lupus erythematosus (SLE) (n = 2). From this cohort, three patients did not undergo the intervention. The second group consisted of an elderly patient with severe left ventricular diastolic dysfunction, a young adult with a history of left atrial arrhythmia, and a child with Duchenne muscular dystrophy (DMD). The average ASD size among patients who underwent the intervention was 26.38 mm, with a thick-to-thick dimension measuring 31.15 mm. The procedure was successful in all 13 patients, with the most frequently used device being a 34 mm occluder (range = 28-40 mm). All devices, excluding the initial one, were custom-made atrial septal occluders (Lifetech Scientific). Among the patients, 12 exhibited left-to-right fenestration flow, while one patient experienced fenestration constriction, likely due to occluder overcrowding. The first patient had a handmade 5 mm fenestration in a 40 mm Amplatzer septal occluder, which got closed off at the one-year follow-up. The procedure was well-tolerated hemodynamically in all patients, with no major complications during the peri-procedural period. Short-term follow-up indicated favorable patient progress. ConclusionsFASD closure emerges as a pivotal alternative for intricate scenarios involving secundum ASD coupled with concurrent comorbidities, offering individualized tailored solutions. Alongside the conventional associated comorbidities, such as left ventricular diastolic dysfunction and pulmonary hypertension, FASD devices hold the potential to extend their benefits to patients grappling...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fenestration: Integrating Wings Into the Atrial Septal Occluder for Navigating a Challenging Terrain

Singh,

Mohapatra,

Kumar

et al. 2023

Cureus

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“…Patients of age (5.8 ± 5.1) with weight (16.3 ± 11.5) and controls of age (6.0 ± 4.9) with weight (18.1 ± 12.9) having non-syndromic and non-familial case study were included, after the diagnoses through echo and consultant advice. The fifty normal echo controls were included for the sake of the small ASDs that are not usually diagnose in early ages and the complications hide till 45 years of age in some cases [ 31 – 33 ].…”

Section: Methodsmentioning

confidence: 99%

Congenital septal defects in Karachi, Pakistan: an update of mutational screening by high-resolution melting (HRM) analysis of MTHFR C677T

Ali,

Khan,

Naveed

et al. 2024

Hum Genomics

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Background Congenital heart defects (CHDs) are the heart structural malformations present at birth. Septal defects account for 40% of CHD, including atrial, ventricular and atrioventricular septal defects. In Pakistan, the prevalence of CHD is 3.4 in 1000, and a study estimated that 60,000 babies are born with CHD annually. Methylenetetrahydrofolate reductase (MTHFR), a chief enzyme, involved in the folate metabolism. The missense mutation, C677T (rs1801133), exists in MTHFR gene, results in a MTHFR thermolabile variant having low enzymatic activity. The study is aim to identify the MTHFR C677T variant association with septal defects. Methods Samples of 194 CHD patients (age $$\overline{X }\hspace{0.17em}$$ X ¯ = 5.8 ± 5.1) and 50 normal echo controls (age $$\overline{X }\hspace{0.17em}$$ X ¯ = 6.0 ± 4.9), confirmed by pediatric consultant, were collected. Extracted DNA, quantified by agarose gel electrophoresis and nanodrop, was screened for SNP by high-resolution melting (HRM). Further, HRM results were confirmed using restriction analysis and sequencing. HRM was simply and precisely genotyped the samples within 3 h at low cost. Results Genotypic data suggested that heterozygous mutant (CT) was frequent in congenital septal defect patients (0.26) which was higher than controls (0.143), p > 0.05. Mutant (TT) genotype was not found in this study. Conclusions rs1801133 has lack of significant association with congenital septal defects. The absence of TT genotype in this study suggesting the role of natural selection in targeted population. HRM is an easy, fast and next generation of PCR, which may be used for applied genomics.

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“…Right-sided volume overload can lead to right atrial and ventricular enlargement, pulmonary hypertension, and potentially right heart failure. Patients with ASDs are at increased risk for atrial fibrillation and flutter, infective endocarditis, as well as recurrent pneumonia [9][10][11].…”

Section: Anatomy and Physiologymentioning

confidence: 99%

Adult Congenital Heart Disease in the Emergency Department

Lindor,

Heller,

Hodgson

et al. 2024

JPM

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While congenital heart disease historically was a pathology primarily restricted to specialized pediatric centers, advances in technology have dramatically increased the number of people living into adulthood, the number of complications faced by these patients, and the number of patients visiting non-specialized emergency departments for these concerns. Clinicians need to be aware of the issues specific to patients’ individual congenital defects but also have an understanding of how typical cardiac pathology may manifest in this special group of patients. This manuscript attempts to provide an overview of this diverse but increasingly common group of adult patients with congenital heart diseases, including a review of their anatomical variants, the complications they face at the highest rates, and ways that emergency physicians may need to manage these patients differently to avoid causing harm.

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Atrial Fibrillation and Atrial Septal Defect

Cited by 10 publications

References 34 publications

Fenestration: Integrating Wings Into the Atrial Septal Occluder for Navigating a Challenging Terrain

Fenestration: Integrating Wings Into the Atrial Septal Occluder for Navigating a Challenging Terrain

Congenital septal defects in Karachi, Pakistan: an update of mutational screening by high-resolution melting (HRM) analysis of MTHFR C677T

Adult Congenital Heart Disease in the Emergency Department

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