Percutaneous Treatment of Patent Foramen Ovale and Atrial Septal Defects

Tobis, Jonathan M.; Shenoda, Michael

doi:10.1016/j.jacc.2012.01.086

Cited by 86 publications

(85 citation statements)

References 51 publications

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“…Echo guidance of ASD closure TEE was required in the pivotal trial of the ASO device and continues to be the most widely used technology for ASD assessment, device selection, and guidance during implantation (2,28,29). However the rational to consider TTE guidance as an alternative is driven by some rare reports of TEE-related esophageal perforation in adults and children (6)(7)(8), as well as the fact that TTE-guidance may allow to shorten both procedure time and fluoroscopy time (30) and to avoid general anesthesia and orotracheal intubation in spontaneously breathing children (30,31).…”

Section: Discussionmentioning

confidence: 99%

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Baruteau¹,

Hascoët²,

Fraisse³

2017

J. Thorac. Dis.

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Background: 2D-transesophageal echocardiography (TEE) is routinely performed to guide percutaneous ASD closure in children. We aimed to assess whether two-dimensional (2D)-transthoracic echocardiography (TTE) is a safe alternative for assessment and guidance of atrial septal defect (ASD) closure in unselected children.Methods: We performed a retrospective single-center study including 389 consecutive children aged Results: ASDs were larger and rims deficiencies were more frequent in the TTE-guided group. The procedure was successful in 376 patients [96.7%; 95% confidence interval (CI), 94.4-98.2%]. The success rate tended to be higher in the TTE-versus TEE-guided group (98.0% versus 94.0%, P=0.069). Device migration occurred in 4 patients (1.0%; 95% CI: 0.3-1.6%), all after TEE-guided procedure (P=0.013).Early major adverse events were observed in 5 patients (1.3%; 95% CI: 0.4-3.0%), all in the TEE group (P=0.004). Fluroroscopic time and irradiation dose were not different among the 2 groups (P=0.450 and P=0.130 respectively). After a median follow-up of 7 years (range, 1-16 years), no adverse events was reported. One (0.3%, 95% CI: 0-1.4%) 12-year-old patient developed atrial fibrillation 5 years after the procedure. Pregnancies were uneventful in 72 cases.Conclusions: When a balloon sizing is performed, 2D-TTE imaging is as efficient as 2D-TEE to guide percutaneous ASD closure in children. The procedure can safely be done in spontaneously breathing children under TTE guidance alone in experienced centers.

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Section: Discussionmentioning

confidence: 99%

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Baruteau¹,

Hascoët²,

Fraisse³

2017

J. Thorac. Dis.

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“…6 However, data on large ASDs managed using the ASO are scarce. Ours is the largest study of transcatheter closure of large secundum ASD.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 During the past 15 years, transcatheter closure of isolated secundum ASD has become the preferred treatment strategy in most cases. 5,6 High-volume institutions have reported strong evidence of good long-term outcomes using this strategy. 7,8 However, with large ASDs, the challenges of percutaneous treatment usually result in a preference for surgical closure.…”

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confidence: 99%

Transcatheter Closure of Large Atrial Septal Defects

Baruteau

Petit

Lambert

et al. 2014

Circ: Cardiovascular Interventions

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Background-Data are needed on the safety and efficacy of device closure of large atrial septal defects. Methods and Results-Between 1998 and 2013, 336 patients (161 children <15 years) with large, isolated, secundum atrial septal defects (balloon-stretched diameter ≥34 mm in adults or echocardiographic diameter >15 mm/m 2 in children) were managed using the Amplatzer device, at the Marie Lannelongue Hospital. Transthoracic echocardiographic guidance was used starting in 2005 (n=219; 65.2%). Balloon-stretched diameter was >40 mm in 36 adults; mean values were 37.6±3.3 mm in other adults and 26.3±6.3 mm/m 2 in children. Amplatzer closure was successful in 311 (92.6%; 95% confidence interval, 89%-95%) patients. Superior and posterior rim deficiencies were more common in failed than in successful procedures (superior, 24.0% versus 4.8%; P=0.002; and posterior, 32.0% versus 4.2%; P<0.001). Device migration occurred in 4 adults (2 cases each of surgical and transcatheter retrieval); in the 21 remaining failures, the device was unreleased and withdrawn. After a median follow-up of 10.0 years (2.5-17 years), all patients were alive with no history of late complications. Conclusions-Closure of large atrial septal defects using the Amplatzer device is safe and effective in both adults and children. Superior and posterior rim deficiencies are associated with procedural failure. Closure can be performed under transthoracic echocardiographic guidance in experienced centers. Early device migration is rare and can be safely managed by device extraction. Long-term follow-up showed no deaths or major late complications in our population of 311 patients. (Circ Cardiovasc Interv. 2014;7:837-843.)

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“…The Amplatzer septal occluder, comprising a braided nitinol wire mesh shaped into 2 flat discs with a connecting waist, is a selfcentering, self-expandable device. Although the polyester fabric inserts are sewn into the nitinol wire mesh to promote tissue growth, 4 the thicker woven mesh could cause inflammatory reactions, erosion at the area of contact, and mechanical obstruction to the coronary ostium, which makes it less optimal when considering interaction with the Mitroflow valve. 5,6 In contrast, the Amplatzer vascular plug II is a 3-lobed device with 6 occlusive planes.…”

Section: Fig 7 At the 2-year Follow-up Evaluation Transthoracic Echmentioning

confidence: 99%

Combined Retrograde/Antegrade Approach to Transcatheter Closure of an Aortic Paravalvular Leak

Damluji

Kaynak

Heldman

2015

Texas Heart Institute Journal

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New interventional techniques have made transcatheter closure of aortic paravalvular leaks a viable therapeutic option to treat the sequelae of these defects, including congestive heart failure and hemolysis. We report the transcatheter closure of an aortic paravalvular leak via a combined retrograde/antegrade approach. This was necessary because of difficulty in crossing the defect with a sheath from the retrograde approach. This technique might be useful in application to other difficult structural heart interventions. To our knowledge, this is the first report of a treated paravalvular leak around a Mitroflow® Aortic Pericardial Heart Valve.

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Percutaneous Treatment of Patent Foramen Ovale and Atrial Septal Defects

Cited by 86 publications

References 51 publications

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Transcatheter Closure of Large Atrial Septal Defects

Combined Retrograde/Antegrade Approach to Transcatheter Closure of an Aortic Paravalvular Leak

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