Impact of modified techniques of transcatheter closure in large atrial septal defects (⩾30 mm) with anatomic complexities

Pillai, Ajith Ananthakrishna; Upadhyay, Amarnath; Gousy, Saranya; Handa, Amit

doi:10.1017/s1047951118001099

Cited by 2 publications

(8 citation statements)

References 16 publications

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“…Right ventricular systolic pressure was estimated and documented in patients with tricuspid regurgitation. TEE imaging was done in the standard sweep imaging angles from 0° to 120° [2]. The mitral and aortic valves were also profiled in the 120° sweep.…”

Section: Methodsmentioning

confidence: 99%

“…The parameters assessed in the TEE included size of the defect, shape of the defect (elliptical or round), adequacy of rims, the number of defects, and location with regard to the aortic and mitral valve. Long axis measurement ≥30 mm was defined as large and ≥35 mm as very large [1], [2]. Presence of septal malalignment and septal aneurysm were also documented.…”

Section: Methodsmentioning

confidence: 99%

“…Presence of septal malalignment and septal aneurysm were also documented. The various rims were described according to TEE findings as follows [2]. The aortic rim was measured at 45° short axis.…”

Section: Methodsmentioning

confidence: 99%

“…Transcatheter closure (TCC) has emerged as the first line treatment for the majority of secundum type of atrial septal defects (ASD) [1], [2], [3]. The spectrum of anatomic variation is relatively high in ASD which may challenge the success and even complicate an attempt with TCC with risk of device embolization [3], [4], [5].…”

Section: Introductionmentioning

confidence: 99%

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Spectrum of morphological abnormalities and treatment outcomes in ostium secundum type of atrial septal defects: Single center experience in >500 cases

Pillai

Sinouvassalou

Jagadessan

et al. 2019

Journal of the Saudi Heart Association

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BackgroundTranscatheter closure (TCC) has emerged as the first line treatment option for secundum type of atrial septal defects (ASD). Outcomes of TCC depend upon proper delineation of defect anatomy by transesophageal echocardiography (TEE). Stability and proper placement of the device mandates adequate rims and proper alignment to the septum. Failed or unfavorable morphology for TCC requires referral for surgical repair.MethodsWe prospectively analyzed the ASD patients who were referred for treatment. The morphological features of the defect were evaluated and the outcomes of TCC studied. Patients who undergo TCC and surgical repair were followed for immediate and long-term outcome comparison.ResultsOf the 512 patients who underwent treatment, TCC was attempted in 430/512 (83.2%) patients. It was successful in 393/430 (91.3%) patients. The remaining 119 patients underwent surgical patch closure. Twenty patients had failure of device alignment and device embolization occurred in 17 patients. Very large defect size ≥35 mm, absent or deficient posterior rim, absent/deficient inferior naval rim showed high chances for failure and formed major reasons for surgical referral. The surgical group had higher success (100%) across all anatomic variables. However, they had longer intensive care unit (ICU) and hospital stay (p < 0.001).ConclusionTCC offered a success rate of 91% in complex defects after TEE selection. Very large size and deficient inferior, posterior rims predicted failure of TCC. Surgery offered 100% success and it involved a longer hospital and ICU stay. The long-term clinical results were identical with both treatment modalities.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spectrum of morphological abnormalities and treatment outcomes in ostium secundum type of atrial septal defects: Single center experience in >500 cases

Pillai

Sinouvassalou

Jagadessan

et al. 2019

Journal of the Saudi Heart Association

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“…In addition, it often needs special modified implantation techniques (MIT); balloon assisted technique, right or left upper pulmonary vein techniques, and so on. These MIT increased success rate of implantation 2)3)…”

mentioning

confidence: 98%

Procedural, Early and Long-Term Outcomes after Transcatheter Atrial Septal Defects Closure: Comparison between Large and Very Large Atrial Septal Defect Groups

Jang

2019

Korean Circ J

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Impact of modified techniques of transcatheter closure in large atrial septal defects (⩾30 mm) with anatomic complexities

Cited by 2 publications

References 16 publications

Spectrum of morphological abnormalities and treatment outcomes in ostium secundum type of atrial septal defects: Single center experience in >500 cases

Spectrum of morphological abnormalities and treatment outcomes in ostium secundum type of atrial septal defects: Single center experience in >500 cases

Procedural, Early and Long-Term Outcomes after Transcatheter Atrial Septal Defects Closure: Comparison between Large and Very Large Atrial Septal Defect Groups

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