Pericardial Effusion in Adults Undergoing Surgical Repair of Atrial Septal Defect

Yip, Adrian Y S; Chau, Elaine; Chow, Wing‐Hing; Kwok, On-Hing; Cheung, King‐Loong

doi:10.1016/s0002-9149(97)00231-2

Cited by 15 publications

(17 citation statements)

References 7 publications

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“…Hospital inpatient stay is typically much shorter after device closure than after surgery, with a return to school or work in days instead of weeks. Pericardial effusions, occasionally fatal, are well described following surgical ASD repair, 29 but not after device closure.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of atrial septal defect preserves right ventricular function

Dhillon

Josen²,

Henein³

et al. 2002

Heart

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Objectives: To determine the effects of atrial septal defects (ASD) and their closure on systolic and diastolic right and left ventricular function; and by comparing surgical closure with transcatheter device closure, to establish differences attributable to cardiopulmonary bypass. Design: Cross sectionally guided M mode echocardiographic ventricular long axis function was measured prospectively before and within one week after ASD closure by device in 17 patients and by surgery in 12 patients, and compared with 18 normal subjects. Results: All indices of right ventricular function were impaired after surgery: mean total excursion, −1.89 cm (95% confidence interval (CI), −2.18 to −1.59); peak shortening rate, −9.09 cm/s (−10.82 to −7.35); peak lengthening rate, −9.26 cm/s (−11.09 to −7.43). Total excursion and peak lengthening rate were preserved after device closure, at −0.12 cm (−0.28 to 0.05) and 0.01 cm/s (−2.29 to 2.31), respectively. Left ventricular free wall function was unchanged after closure by either method, while all septal measurements were reduced after closure by either method (changes ranging from −3.51 to −0.32; 95% CI ranging from −4.90 to −0.13). Conclusions: Left ventricular free wall function is unaffected by ASD closure, whereas septal function is impaired, irrespective of the method of closure. Right ventricular function, both systolic and diastolic, is impaired by cardiopulmonary bypass but preserved after device closure. These findings support the transcatheter approach to ASD closure in anatomically suitable defects.

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Section: Discussionmentioning

confidence: 99%

Transcatheter closure of atrial septal defect preserves right ventricular function

Dhillon

Josen²,

Henein³

et al. 2002

Heart

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“…[13][14][15] It may be accompanied by significant morbidity and rarely, by mortality. PPS was diagnosed clinically and confirmed by echocardiogram Sinus Venosus Atrial Septal Defect Russell in 4 patients (9.1%); only one required drainage.…”

Section: Discussionmentioning

confidence: 99%

Outcome following Repair of Sinus Venosus Atrial Septal Defects in Children

Russell

LeBlanc

Deagle

et al. 2002

Asian Cardiovasc Thorac Ann

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The outcome of surgical repair of sinus venosus atrial septal defect was reviewed retrospectively. The operation was performed on 44 children aged 8 to 163 months, between April 1985 and November 1998. Median cardiopulmonary bypass and aortic crossclamp times were 58 minutes (range, 29 to 141 minutes) and 29 minutes (range, 4 to 67 minutes), respectively. Use of blood products decreased from 4.5 units per patient in the first period (1985 to 1989) to 0.6 units in the last period (1995 to 1998). Median intensive care and hospital stays were 2 days (range, 1 to 12 days) and 6 days (range, 4 to 16 days), respectively. There was 1 early death (2.3%). Complications included reexploration for bleeding in 2 patients (4.5%) and for superior vena cava obstruction in 1 (2.3%), and arrhythmias in 3 (6.8%), which required a pacemaker in one. During follow-up of 15 to 176 months, 83.8% of patients were in sinus rhythm. One required angioplasty for superior vena cava stenosis, hemodynamically insignificant residual shunt was found in 3, and mild superior vena cava stenosis in 3. Repair of sinus venosus atrial septal defect carries a low mortality and morbidity, but long-term follow-up is needed to monitor potential sinus node dysfunction and superior vena cava stenosis.

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“…The advantages of the interventional treatment compared to the cardiosurgical approach are obvious. Although mortality is rarely seen after surgery [8], morbidity related to thoracotomy and pericardiotomy, cardiopulmonary bypass, and possible risks of blood transfusions are more frequently observed [8,9]. Elderly patients have shown increased incidence of postoperative complications [2].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter treatment of coronary artery disease and atrial septal defect with sequential implantation of coronary stent and Amplatzer septal occluder: Preliminary results

Onorato¹,

Pera²,

Lanzone³

et al. 2001

Cathet Cardio Intervent

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Coronary stent implantation had been established as a highly effective revascularization technique in patients with occlusive coronary artery disease. Transcatheter closure of atrial septal defects is becoming a definite alternative to surgery in properly selected patients. During a 19-month period, 6 patients (50% women; mean age, 58 +/- 17 years; range, 32-73 years) of a consecutive series of 176 prospective multicenter registry patients undergoing transcatheter atrial septal defect closure were treated with sequential percutaneous coronary revascularization and Amplatzer septal occluder implantation. Indication for revascularization was stable angina in four patients and unstable angina in two. Indication for defect closure was significant left-to-right shunt with right ventricular enlargement. Defect diameter ranged from 13 to 20 mm by transesophageal echocardiography, and the stretched diameter measured 13 to 25 mm. Procedural success of both interventions was achieved in all cases without in-hospital complications. A total of seven stents were successfully implanted in five coronary vessels. No stent was used in one patient after successful PTCA. Immediate total closure of the defect was obtained in five patients. Trivial residual shunting, observed in one patient, disappeared at 24 hr. No adverse cardiac events, recurrence of anginal symptoms, or evidence of residual shunt were observed at clinical and echocardiographic follow-up, which ranged from 60 to 390 days (mean, 258 +/- 150 days). These results suggest that sequential transcatheter therapy of coronary artery disease and atrial septal defect is safe and efficacious in selected patients.

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Pericardial Effusion in Adults Undergoing Surgical Repair of Atrial Septal Defect

Cited by 15 publications

References 7 publications

Transcatheter closure of atrial septal defect preserves right ventricular function

Transcatheter closure of atrial septal defect preserves right ventricular function

Outcome following Repair of Sinus Venosus Atrial Septal Defects in Children

Transcatheter treatment of coronary artery disease and atrial septal defect with sequential implantation of coronary stent and Amplatzer septal occluder: Preliminary results

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