Long-Term Outcome after Surgical Repair of Isolated Atrial Septal Defect

Murphy, Joseph G.; Gersh, Bernard J.; McGoon, Michael D.; Mair, Douglas D.; Porter, Co Burn J.; Ilstrup, Duane M.; Puga, Francisco J.; Kirklin, John W.; Danielson, Gordon K.

doi:10.1056/nejm199012133232401

Cited by 713 publications

(415 citation statements)

References 29 publications

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“…Previously it has been established that surgical closure of an ASD in children or adults with symptoms is of symptomatic, haemodynamic and prognostic benefit [1,2]. The upper age limit at which these benefits have been shown was extended by Attie et al who randomised over 500 patients aged over 40 (mean age 51 but including over 100 patients aged ">60") to medical treatment or surgical closure [3].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment options include medical management, percutaneous closure and open surgical closure. There is clear evidence that children and young adults with an ASD and consequent symptoms, or who are asymptomatic but are shown to have a haemodynamically significant shunt, do better symptomatically, haemodynamically and in terms of survival if the ASD is closed [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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Short and medium-term effects of secundum atrial septal defect percutaneous closure using the Amplatzer Septal Occluder in the elderly

Broadley¹,

Gogola²,

Roobottom³

et al. 2017

Blood Heart Circ

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Aim: to assess the effects of percutaneous secundum atrial septal defect (ASD) closure in the elderly. Methods and results:Descriptive, retrospective study in a large Regional University Teaching Hospital. Subjects were 11 patients aged over 60 (mean age 72 [range 62 to 83], 3 male) at the time they underwent percutaneous closure of a secundum ASD using an Amplatzer septal occluder (ASO). Post-closure the following parameters were significantly reduced: heart size on serial chest X-ray, from a mean (standard deviation) of 16.7 (2.1) cm to 14.8 (1.3) cm (p=0.016) after 4.5 (2.1) months; pulmonary vascularity on serial chest X-ray; right ventricular diastolic diameter on serial transthoracic echocardiogram, from 4.2 (0.8) cm to 3.0 (0.74) cm (p<0.001) after a mean of 15 (12.2) months; and right ventricular systolic pressure measured indirectly (n=4). Symptoms, particularly shortness of breath, also seemed to improve although they were not quantitatively assessed.Conclusion: percutaneous closure of ASD in the elderly using an ASO results in significant reduction in right ventricle and pulmonary artery size, improved haemodynamics and probably also symptoms. On this basis it should be considered in all cases where it is technically feasible, in preference to continuing medical therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short and medium-term effects of secundum atrial septal defect percutaneous closure using the Amplatzer Septal Occluder in the elderly

Broadley¹,

Gogola²,

Roobottom³

et al. 2017

Blood Heart Circ

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“…Secundum atrial septal defect (ASD) can cause arrhythmia, pulmonary hypertension, and reduced life expectancy. [1][2][3] Patent foramen ovale (PFO) is associated with stroke, systemic embolism, and neurological decompression illness in divers. [4][5][6][7] Surgical closure of ASD in adults carries low mortality but significant morbidity.…”

Section: Introductionmentioning

confidence: 99%

Closure of defects of the atrial septum in adults using the amplatzer device:100 consecutive patients in a single center

Purcell

Brecker

Ward

2004

Clinical Cardiology

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SummaryBackground: Transcatheter device closure of atrial septal defects (ASD) is an alternative to surgery, but experience is limited in adults, especially in those with large (> 26 mm) defects.Hypothesis: We investigated the safety, efficacy, and learning curve for closure of ASD and patent foramen ovale (PFO) using the Amplatzer device.Methods: In all, 101 procedures were carried out in 100 consecutive adult patients in a single cardiac center between July 1998 and August 2002.Results: Preprocedure diagnosis was ASD and PFO in 50 patients each. A device was deployed in 94 of 101 attempts (93%) in 94 of 100 patients (94%). Atrial septal defect device sizes were 10-38 mm, median 24 mm, and 40% were > 26 mm. Major complications occurred in 2 of 100 patients (2%). One ASD device displaced requiring surgery within 24 h and one patient with PFO experienced pericardial tamponade; there were no deaths. Local vascular complications occurred in 4 of 100 (4%) and late complications in 4 of 100 (4%) patients. Patent foramen ovale closure was quicker (p < 0.001), required less radiation (p = 0.04), and was associated with fewer local vascular complications than ASD closure (p = 0.04). Deployment of ASD devices > 26 mm was not associated with increased complications, length of procedure, or radiation compared with devices ≤ 26 mm (all p > 0.05). Complications in the first 35 patients were more frequent than in subsequent patients: 7 of 35 (20%) versus 3 of 65 (4.6%) (p = 0.04); proce-

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“…A lthough surgical repair of interatrial communications and PDA is a safe, widely accepted procedure with negligible mortality, it is associated with morbidity, discomfort and a thoracotomy scar [1]. As an alternative to surgery, a variety of devices for transcatheter closure of ASDs have been developed over the past 25 years, but none has gained wide acceptance.…”

Section: Introductionmentioning

confidence: 99%

Amplatzer Device closure of Atrial Septal Defects and Patent Ductus Arteriosus: Initial Experience

Dugal

Jetley

Singh

et al. 2003

Medical Journal Armed Forces India

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Surgical closure of Atrial Septal Defects (ASD) and Patent Ductus Arteriosus (PDA) can be performed successfully with low mortality. However, the morbidity associated with general anaesthesia, thoracotomy, cardiopulmonary bypass, postoperative monitoring in the intensive care unit, several days of hospital stay and the requirement of blood products is considerable. The expense associated with this morbidity, operative scar and the psychologic trauma to the patient and parents are additional disadvantages of surgery. Hence, the closure of these defects by transcatheter methods with various devices has been evaluated worldwide. We report the initial experience at our centre with closure of secundum ASDs and large PDAs with the Amplatzer Septal Occluder and Amplatzer Duct Occluder.

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Long-Term Outcome after Surgical Repair of Isolated Atrial Septal Defect

Abstract: Among patients with surgically repaired atrial septal defects, those operated on before the age of 25 have an excellent prognosis, but older patients require careful, regular supervision.

Cited by 713 publications

References 29 publications

Short and medium-term effects of secundum atrial septal defect percutaneous closure using the Amplatzer Septal Occluder in the elderly

Short and medium-term effects of secundum atrial septal defect percutaneous closure using the Amplatzer Septal Occluder in the elderly

Closure of defects of the atrial septum in adults using the amplatzer device:100 consecutive patients in a single center

Amplatzer Device closure of Atrial Septal Defects and Patent Ductus Arteriosus: Initial Experience

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