Long-Term Outcomes After Percutaneous Closure of Ostium Secundum Atrial Septal Defect in the Young

Jalal, Zakaria; Hascoët, Sébastien; Gronier, Céline; Godart, François; Mauri, Lucia; Dauphin, Claire; Lefort, Bruno; Lachaud, Matthias; Piot, Dominique; Dinet, Marie–Lou; Levy, Yaël; Fraisse, Alain; Ovaert, Caroline; Pillois, Xavier; Lusson, Jean-René; Petit, Jérôme; Baruteau, Alban‐Elouen; Thambo, Jean-Benoît

doi:10.1016/j.jcin.2018.01.262

Cited by 57 publications

(68 citation statements)

References 36 publications

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“…The IMPACT review of 1,564 ASD device closures demonstrated no residual leak (>3 mm) in GSO implants, 0.6% in the Helex Septal Occluder, and 1.8% with the Amplatzer Septal Occluder (ASO). Importantly, patients with deficient superior rim accounted for 40% of the IMPACT cohort, similar to that reported in the national French study (28.3%), but much higher than the prospective, multicenter U.S. study of the ASO (11.5%) . One approach that we have utilized in specific ASD morphology (i.e., larger defects with deficient retroaortic rim) is to implant a larger GSO if the septal length and left atrium can safely accommodate the device.…”

Section: Discussionmentioning

confidence: 46%

Here today, gone tomorrow: Outcomes of residual leak following secundum atrial septal defect closure with the GORE CARDIOFORM Septal Occluder

Gordon

Abudayyeh

Goble

et al. 2019

Cathet Cardio Intervent

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Objective: To assess the outcomes and potential predictors of residual leak after implantation of the GORE CARDIOFORM Septal Occluder (GSO) in secundum atrial septal defects (ASDs). Background:The non-self-centering design of the GSO could lead to residual leak at the edge of the device. Outcomes of residual leak are poorly understood.Methods: Retrospective, multicenter review of patients treated with the GSO for the pivotal and continued access study. Procedural, echocardiographic, and follow up data were reviewed. Multivariate analysis was performed to determine predictors of leak at implant and outcomes of these leaks.Results: There were 370 total ASD device closures with the GSO, 65 (17.56%) of which were found to have residual leak at implantation. Patients with residual leak had larger defects (10.33 ± 3.05 mm vs. 9.13 ± 2.89 mm, p = .006) and smaller aortic rims (4.87 ± 3.33 mm vs. 6.17 ± 3.78 mm, p = .019), as compared to those without leak. Larger devices were implanted (p = .008) and more devices per case (p = .007) were utilized in the residual leak cohort as compared to those without leak. Overall, among patients with residual leak, there was a significant decrease in leak size over 1 year, from 1.55 ± 0.75 mm to 0.25 ± 0.74 mm (p < .001), with the majority (87.6%) disappearing by 12-month follow-up. Conclusions:Residual leak at implantation can be seen after ASD device closure with the GSO, more commonly in larger defects with smaller retroaortic rims. The vast majority of these leaks completely resolve by 1 year follow up.

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Section: Discussionmentioning

confidence: 46%

Here today, gone tomorrow: Outcomes of residual leak following secundum atrial septal defect closure with the GORE CARDIOFORM Septal Occluder

Gordon

Abudayyeh

Goble

et al. 2019

Cathet Cardio Intervent

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“…A total of 91 consecutive pediatric patients (38 males; median age 5.0 years [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]; median weight 20 kg ) underwent successful GSO implantation at least 1 year before study enrollment. Patients' baseline characteristics are summarized in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Refinements of the devices and materials have contributed to greater procedural safety and facilitated percutaneous treatment even in more complex lesions and younger infants . Despite excellent results, potential serious device‐related complications remain worrying, like cardiac erosion, device embolization, thromboembolic events, significant rhythm or conductance disturbance, as well as device fatigue failure resulting in instability and fragmentation . The patch‐like Gore devices (W.L.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Despite excellent results, potential serious device-related complications remain worrying, like cardiac erosion, device embolization, thromboembolic events, significant rhythm or conductance disturbance, as well as device fatigue failure resulting in instability and fragmentation. [5][6][7][8][9][10][11][12][13][14] The patch-like Gore devices (W.L. Gore & Associates, Flagstaff, AZ, USA) offer some potential benefits owing to their soft and conformable constructions.…”

Section: Introductionmentioning

confidence: 99%

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Wire‐frame integrity of patch‐like Gore devices following atrial septal defect closure

Kubicki

Fingerhut

Uhl

et al. 2019

Cathet Cardio Intervent

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Objectives To assess the structural integrity of the patch‐like Gore Septal Occluder (GSO) used for device closure of secundum‐type atrial septal defects (ASD II) in pediatric patients. Background GSO has shown to be effective and safe for ASD device closure in children and adolescents. Methods Single‐center, retrospective mid‐ to long‐term follow‐up of all children and adolescents with a GSO in situ (≥12 months). Periprocedural data and follow‐up data were evaluated, including chest X‐rays to assess the GSO's wire‐frame morphology. Results Ninety‐one consecutive patients were enrolled with a median age and weight of 5 years (range 2–18) and 20 kg (range 11–95) at implantation. ASD anatomy included 64 single and 27 multi‐fenestrated defects, with 39 patients having small retro‐aortic rims (≤4 mm). Median follow‐up period was 42.5 months (range 12–74). Chest X‐rays were available in 80 children: in 74 of them, the GSO's visualization on X‐ray enabled us to reliably assess the wire‐frame structure. Wire‐frame fracture (WFF) was ultimately detected in five of the 74 patients (6.8%); however, those occluders appeared stably anchored and well aligned to both sides of the septum, and no free wire fragments had escaped the GSO matrix. Thus, no further treatment was required. Conclusions Our data confirm that the GSO is safe and effective for ASD closure. Despite its lightweight construction, the GSO seems to offer reliable mechanical durability. Wire‐frame fractures occur, but the free wire‐ends appear to have remained stable within the GSO matrix without any clinical sequelae so far.

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“…Además, la persistencia de hemocultivos positivos o de clínica séptica, a pesar del tratamiento médico, sería indicación relativa de retirada del dispositivo. 6 En el caso presentado, dado el buen estado general del paciente, la ausencia de inestabilidad del dispositivo y la ausencia de complicaciones con clara indicación quirúrgica, se optó por un manejo conservador con tratamiento antibiótico endovenoso. Nuestro caso es el primero publicado, ya que, tras una exhaustiva revisión bibliográfica, no se han encontrado otros reportes en la población pediátrica en los que se realice un manejo exitoso totalmente conservador, sin retirada del dispositivo.…”

Section: Figura 2 Ecocardiografía Transtorácica 2d No Se Aprecian Iunclassified

Endocarditis tardía en un portador de un Amplatzer. Manejo conservador en un paciente pediátrico

Morillo¹,

Pintre²,

González

et al. 2019

Arch Argent Pediat

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Presentación de casos clínicos RESUMENDesde su aparición, las técnicas percutáneas han ido sustituyendo la cirugía convencional como tratamiento de primera línea en los defectos septales interauriculares. Los dispositivos Amplatzer fueron los primeros aprobados por la Food and Drug Administration, y su colocación se ha convertido en un procedimiento habitual en cardiología pediátrica. La aparición de endocarditis bacteriana sobre este tipo de dispositivos es muy infrecuente. Se presenta el caso de una endocarditis bacteriana en un paciente pediátrico portador de un dispositivo Amplatzer, que se manejó de forma conservadora con antibioterapia intravenosa, con evolución satisfactoria. Palabras clave: endocarditis, Amplatzer, dispositivo oclusor septal, tratamiento conservador. ABSTRACTSince their introduction, percutaneous techniques have been replacing conventional surgery as a first-line treatment for septal defects. Amplatzer devices were the first to be approved by the Food and Drug Administration, and their placement has become a standard procedure in pediatric cardiology. Bacterial endocarditis of intracardiac devices such as the Amplatzer septal occluder is very infrequent. We report a case of bacterial endocarditis in a pediatric patient with an Amplatzer device, who developed an infectious endocarditis six years after its placement and received conservative management with intravenous antibiotics, with satisfactory evolution.

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Long-Term Outcomes After Percutaneous Closure of Ostium Secundum Atrial Septal Defect in the Young

Cited by 57 publications

References 36 publications

Here today, gone tomorrow: Outcomes of residual leak following secundum atrial septal defect closure with the GORE CARDIOFORM Septal Occluder

Here today, gone tomorrow: Outcomes of residual leak following secundum atrial septal defect closure with the GORE CARDIOFORM Septal Occluder

Wire‐frame integrity of patch‐like Gore devices following atrial septal defect closure

Endocarditis tardía en un portador de un Amplatzer. Manejo conservador en un paciente pediátrico

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