Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44–48 mm), a single Chinese cardiac center experience

Chen, Qiang; Cao, Hua; Zhang, Gui-Can; Xu, Fan; Zhang, Jiaxin

doi:10.1186/s13019-017-0639-8

Cited by 8 publications

(6 citation statements)

References 32 publications

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“…In some series, complete closure (with no residual shunt) was achieved less often by the percutaneous method 20, 21. Similarly, in our study, the success rate of device closure was lower than surgical closure.…”

Section: Discussionsupporting

confidence: 66%

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Askari

Soraya

Ayremlu

et al. 2018

The Egyptian Heart Journal

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ObjectivesAtrial Septal Defect (ASD) accounts for 10% of congenital cardiac defects. The purpose of this retrospective study was to compare the short-term outcomes of surgical versus trans catheter closure of secundum atrial septal defect.MethodsThis is a single-center retrospective cohort study in patients who had surgical or trans catheter ASD closure. ASD closure outcomes such as hospital cost, length of hospital and ICU stay, residual ASDs, complications, readmission, hospital and three month mortality were recorded and compared.ResultsBetween March 2010 and March 2016, total of 102 secundum ASD patients were treated in our center (71 patients surgical ASD closure and 31 patients trans catheter ASD closure). About 13.9% of patients (5/36) in the device group had failed procedural attempt for various reasons and these patients underwent surgery closure. Complete closure was observed in 26 of 31 patients (83.9%) in the device group and in 70 of 71 patients in the surgery group (98.6%). The mean length of hospital stay was 5.56 days for surgical group and 2.06 days for device group. The procedure cost for surgery was found to be 5.7% lower than trans catheter closure (patient payment). The complication rates were 18.3% for surgical group and 25.8% for the device group. Readmission after discharge was more common in surgery group (11.2 vs 6.4%). Hospital and three months mortality in both groups were zero.ConclusionsBoth trans catheter and surgical procedure are good methods of successful ASD closure. Considering that the surgical group patients were higher risk patients, mean total hospital cost of patient's procedures were significantly higher in device closure group, failed intervention rate and residual ASD were more common in device group and complications of device group were more serious; thus, appropriate patient selection is an important factor for successful device closure.

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Section: Discussionsupporting

confidence: 66%

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Askari

Soraya

Ayremlu

et al. 2018

The Egyptian Heart Journal

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“…It is performed under the guidance of esophageal ultrasound and has no restrictions with respect to radiation-related injury or age. The delivery sheath remains perpendicular to the atrial septal plane during the procedure, but a chest wall incision of 1.0-1.5 cm is required for intrapleural cavity operation [13][14][15][16]. A right jugular vein approach can largely solve the problems of the common surgical methods listed above.…”

mentioning

confidence: 99%

Analysis of the therapeutic effect of transesophageal echocardiography‐guided percutaneous device closure of atrial septal defects via the right internal jugular vein in children

Gao¹,

Zhao

et al. 2019

Echocardiography

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Background Traditional X‐ray‐guided transcatheter closure of atrial septal defects (ASDs) via the right femoral vein carries a risk of radiation damage, which is greatly exacerbated by age and vascular conditions. Transesophageal echocardiography (TEE) guidance for the closure procedure not only broadens the indications of interventional therapy for ASDs but also avoids radiation exposure. Purpose To assess the value of TEE‐guided ASD device closure via the right internal jugular vein (RIJV) in children. Methods Nineteen pediatric patients with secondary ASD underwent TEE‐guided ASD device closure via the RIJV from July 22, 2015 to July 19, 2017. After the RIJV was successfully accessed, one Fustar curve‐adjustable delivery sheath was inserted. The implant depth was adjusted, and the tip of the sheath was curved to facilitate passage through the ASD for the delivery and release of the occluder. TEE was used to guide the entire procedure. Results In all 19 patients, the ASDs were successfully closed and the occluder was confirmed to have a stable position and good shape, with no residual shunt. During the follow‐up period (2 months to 2 years), no pericardial effusion, thrombosis, tachyarrhythmia, atrioventricular block, or other complications were observed. Conclusions An adjustable delivery sheath can be used to treat ASD via the RIJV. This procedure has varied indications, and its advantages include a short operation path, procedural accuracy, minimal trauma, and quick recovery, especially for young patients with large ASDs and cases in which a femoral vein approach is difficult. The procedure has great clinical significance and merits attention.

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“…[ 7 ] A different form of a 48 mm nitinol septal occluder was used for hybrid peratrial device closure, where the technique used a large sheath through an atrial purse string using ministernotomy. [ 8 ] The right atrial hub of this device was attached to a suture to enable surgical retrieval, indicating a different design altogether from the routine transcatheter devices.…”

Section: Discussionmentioning

confidence: 99%

Experience with the largest custom-made 48 mm fenestrated atrial septal occluder device and its 4-year follow-up

Sivakumar¹,

Jain²

2023

Annals of Pediatric Cardiology

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Atrial septal defects (ASDs) measuring <38 mm are referred for transcatheter closure. Availability of larger devices up to 46 mm extended the inclusion criteria. An elderly hypertensive male with a 44 mm secundum ASD and coexistent sick sinus syndrome and atrioventricular (AV) nodal block presented with syncope. Balloon interrogation unmasked restrictive left ventricular (LV) physiology. After AV synchronous pacing, balloon-assisted deployment of a custom fenestrated 48 mm Figulla septal occluder (Occlutech Inc., Schaffhausen, Switzerland) prevented a rise of LV end-diastolic pressures beyond 12 mmHg. Echocardiogram and computed tomography after 4 years confirmed a patent fenestration and favorable remodeling. This report of the clinical use of the largest ASD device demonstrated the feasibility of closure of extremely large defects despite a restrictive LV.

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Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44–48 mm), a single Chinese cardiac center experience

Cited by 8 publications

References 32 publications

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran

Analysis of the therapeutic effect of transesophageal echocardiography‐guided percutaneous device closure of atrial septal defects via the right internal jugular vein in children

Experience with the largest custom-made 48 mm fenestrated atrial septal occluder device and its 4-year follow-up

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