Failure of devices used for closure of atrial septal defects: Mechanisms and management

Agarwal, Surendra Kumar; Ghosh, Piyali; Mittal, Payal

doi:10.1016/s0022-5223(96)70173-3

Cited by 65 publications

(36 citation statements)

References 19 publications

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“…Intraprocedural ICE and TEE and postprocedural TTE are useful for identifying complications of percutaneous closure. 19,[22][23][24] This article will review important complications of percutaneous ASD/PFO closure, with an emphasis on the role of echocardiography for their diagnosis and management. …”

mentioning

confidence: 99%

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Yared

Baggish

Solı́s

et al. 2009

Circ: Cardiovascular Imaging

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mentioning

confidence: 99%

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Yared

Baggish

Solı́s

et al. 2009

Circ: Cardiovascular Imaging

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“…24 The Amplatzer Septal Occluder has recently been developed as a new device, 25 and although some favorable results compared with conventional surgical closure have been reported, 26 -28 limitations remain, including the need for patient selection in terms of age, body weight, and type of ASD, as well as a lower success rate than that of surgical closure. If a surgical approach could be accomplished with an incision size the same as that of per-catheter techniques, a minimally invasive, off-pump surgical approach would offer significant advantage.…”

Section: Discussionmentioning

confidence: 99%

Beating Atrial Septal Defect Closure Monitored by Epicardial Real-Time Three-Dimensional Echocardiography Without Cardiopulmonary Bypass

et al. 2003

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Background-We assessed the feasibility of beating atrial septal defect (ASD) closure monitored by real-time 3D echocardiography (RT3DE). Methods and Results-RT3DE was developed with prototype ultrasound equipment consisting of a high-speed 3D rendering unit with a frame rate of 5 to 10 frames/s. We also developed a prototype semiautomatic suture device and suture cutting system. In the experiment, 12 mongrel dogs were anesthetized, and after median sternotomy, the echo probe was applied directly to the surface of the right atrium. Three surgical maneuvers (balloon atrial septectomy, enlargement of the ASD, and ASD closure) were performed through the atrial port inserted into the right atrial appendage. The heart was then excised, and the area of the ASD measured by RT3DE was compared with its area measured directly. The ASD was successfully closed in all experimental animals except the first 2. Examination of the excised heart showed that none of the sutures were loose. The mean area of the ASD was 82.5Ϯ38.6 mm 2 when measured by RT3DE and 81.6Ϯ38.2 mm 2 when measured directly, and there was a significant correlation between the areas measured by RT3DE and those measured directly (echo measurementsϭ1.007ϫdirect measurementsϩ0.337; PϽ0.0001). A Bland-Altman analysis revealed close agreement between the results obtained by the 2 methods (7.807 mm 2 upper and Ϫ6.024 mm 2 lower limit of agreement). Conclusions-Introduction

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“…In the context of a freshly implanted buttoned device, complete or partial device retrieval can be followed by implantation of a second, larger device [20]. An emergency operation to retrieve the device and close the defect also may be necessary [21]. Residual shunts may decrease or even disappear at follow-up [22], however, which makes it advisable not to treat residual shunts early after implantation, unless there is a complication.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter occlusion of complex atrial septal defects

Lezo

Medina

Pan

et al. 2000

Cathet. Cardiovasc. Intervent.

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Percutaneous device occlusion of secundum atrial septal defects (ASDs) is becoming an accepted alternative to surgical closure. This method allows us to evaluate patients with complex conditions for treatment. From a total of 70 patients with ASD evaluated for percutaneous closure, we selected for analysis 28 who had complex conditions. The mean age was 36+/-23 yr (range, 4-72). Six had heart failure, and of these six, three had atrial fibrillation. At cardiac catheterization, the pulmonary pressure was 47+/-24 mm Hg, and the QP/QS was 1.7+/-0.4; two patients had bidirectional shunt and systemic pulmonary pressure. Two patients received a buttoned device and 26 an Amplatzer septal occluder. The groups of patients with complex conditions were separated into the following groups. Group I (n = 4) underwent combined treatment of associated anomalies. Two patients had pulmonary stenosis, one had mitral stenosis, and one had an aortic root-left atrium fistula. They were treated in or during with the same procedure by combined transcatheter techniques (balloon valvuloplasty and fistula occlusion) before ASD occlusion. Group II (n = 9) had multiple defects (cribiform or two separate holes). They were treated with a single device in five instances and with two separate devices in four cases. Group III (n = 14) had large (32+/-3 mm) single defects. Nine of them underwent successful implantation using a device 33+/-3 mm in diameter; in the remaining five patients the device was removed because of instability. Group IV (n = 3) had residual defects after previous partial device occlusion. All three defects were successfully occluded with a second device. No movement or interference with the first device was observed. Group V (n = 6) had severe pulmonary hypertension (86+/-16 mm Hg). Immediately after ASD occlusion we observed significant relief in these patients (67+/-14 mm Hg; P<0.01). There were no major complications; all 23 patients with successful implants were discharged without symptoms 2-7 days later; one patient with atrial fibrillation recovered sinus rhythm. The follow-up (8+/-5 mo) Doppler echo study showed complete ASD occlusion in 22 patients and a peak pulmonary pressure of 30+/-14 mm Hg. We conclude that transcatheter occlusion of ASDs is an effective and safe treatment for patients with complex anatomic or physiopathologic conditions, as evaluated by short-term follow-up.

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Failure of devices used for closure of atrial septal defects: Mechanisms and management

Cited by 65 publications

References 19 publications

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Beating Atrial Septal Defect Closure Monitored by Epicardial Real-Time Three-Dimensional Echocardiography Without Cardiopulmonary Bypass

Transcatheter occlusion of complex atrial septal defects

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