Peri-operative complications following surgical closure of atrial septal defect type II in 232 patients—a baseline study

Abstract

This study intends to provide a detailed overview of the types and rates of peri-operative complications after surgical correction of an isolated ASD II. The transvenous approach to the occlusion of atrial septal defects has yielded promising results during its first 5 years of clinical trials, but before it can be established as a routine measure, definite proof is needed to demonstrate that its rate of serious complications does at least not exceed that of the surgical closure. Between 1985 and 1992, 232 consecutive patients underwent surgical closure of a secundum atrial septal defect. Among the patients 118 were children (< 18 years; 79 girls and 39 boys) with a mean age of 8.9 +/- 5.2 years (4 months-17 years) and 114 adults (74 women and 40 men) with a mean age of 28.5 +/- 10.8 years (18-69 years). Pre-operatively eight children (6.8%) and eight adults (7%) were treated for right heart failure. Mean pulmonary artery pressure was 20.4 +/- 10.4 mmHg for the children and 19.3 +/- 7 mmHg for the adults. The average pulmonary artery to systemic flow ratios were 2.9:1 and 3:1 for children and adults, respectively. Thirty children (25.4%) and 15 adults (13.2%) underwent patch closure while direct suture was the method used for the remaining patients. Average cardiopulmonary bypass time was 35.7 +/- 17.9 min for the children and 41.5 +/- 19.9 min for the adults. The length of the procedure (skin to skin) was a mean of 116 min in the young group, and 141 min in the adult group.(ABSTRACT TRUNCATED AT 250 WORDS)

Pediatric Therapeutic Cardiac Catheterization

“…The standard for managing clinically significant ASDs is surgical closure, which is associated with less than 1% mortality. The incidence of residual shunting on long-term follow-up is as high as 7.8%, 91 and significant morbidity 92 is associated with surgical closure.…”

Thoracoscopic ASD closure is a reliable supplement for percutaneous treatment

“…[8][9][10][11] However, cardiac surgery and medicine as a whole are strongly evolving in a minimally invasive direction. Moreover, the advent of transcatheter closing devices has substantially shifted the treatment of (secundum) ASDs from the surgeon towards the interventionalist.…”

Transcatheter Closure of Atrial Septal Defect with a CardioSEAL Device

“…26) Although children with ASDs are usually asymptomatic, closure of this defect is still strongly recommended in childhood to avoid possible complications in later years. [1][2][3][4][5] Surgical correction either by an open heart procedure or by a video-assisted scopic method usually involves some risks. 4,5) A surgical scar on the chest is unavoidable.…”

“…[1][2][3][4][5] Surgical correction either by an open heart procedure or by a video-assisted scopic method usually involves some risks. 4,5) A surgical scar on the chest is unavoidable. In view of this transcatheter closure of ASD, this device will be the preferred choice for patients with proper size and location of ASD.…”

“…1,2) Although it is usually asymptomatic in infancy and childhood, surgery is frequently suggested in the preschool age. [1][2][3][4][5] Transcatheter closure with different devices, such as Rashkind umbrella, Sideris' occluder, angel wings device, ASDOS occluder, and Clamshell device have been tried on human beings within the last 20 years. [6][7][8][9][10][11][12][13][14][15] The initial results were reported as acceptable, but opinions on the best device for transcatheter closure of ASD vary widely.…”