Techniques and outcomes of transcatheter closure of complex atrial septal defects – Single center experience

Pillai, Ajith Ananthakrishna; Satheesh, Santhosh; Packirisamy, Gobu; Selvaraj, Raja; Jayaraman, Balachander

doi:10.1016/j.ihj.2013.12.016

Cited by 17 publications

(22 citation statements)

References 8 publications

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“…The presence of multiple defects of the inter-atrial septum have been reported between 5.3% to 7.3% of patients with ostium secundum ASD. 2,6,7 In our study Aortic rim was absent in 63.3 % patients, it is the rim which is most commonly absent in ASD secundum patients. Though absent Aortic rim is not a contraindication for device closure, its absence makes device closure procedure complex.…”

Section: Discussionsupporting

confidence: 48%

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Assessment of atrial septal defects rims on transesophageal echocardiogram at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

2017

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Background and Aims: Transcatheter Atrial septal defects (ASD) closure has become the better alternative to surgical closure. Morphological variations of ASD are frequent. We aim to study the rims of ASD in Transesophageal echocardiogram (TEE). Methods: It was a retrospective single center audit done at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. TEE clips of all the patients who underwent TEE evaluation for ASD device closure in our centre between June to August 2017 were studied. Results: During the study period 49 patients underwent TEE to evaluate the rims of ASD for device closure. Atrioventricular rim was good in all patients but it was floppy in one patient. In four chamber view, posterior rim was good in 21(42.8%) patients, floppy in 19 (38.7%) patients and absent in nine (18.5%) patients. Aortic rim was good in 15 (30.6%) patients, floppy in three (6.1%) patients and absent in 31(63.3%) patients. Posterior rim in short axis was good in 17 (34.6%) patients, floppy in 24 (48.9%) patients while it was absent in eight (16.3%) patients. Inferior venacava rim was good in 16 (32.6%) patients, floppy in 23 (46.9%) patients, while absent in ten (20.4%) patients. Superior venacava rim was good in 45 (91.8%) patients, floppy in one (2.1%) patient and absent in three (6.1%) patients. Two (4.1%) patients had two ASDs. Conclusion: Most of the ASD patients have absent rims which makes the procedure more demanding and challenging.

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Section: Discussionsupporting

confidence: 48%

“…Deficient/floppy posterior rim was present in 30.6% patients. 6 IVC rim is the most important rim for ASD device closure, absence of IVC rim is considered contraindication for Device therapy. IVC rim was absent in 20% patients and floppy in 47% patients.…”

Section: Discussionmentioning

confidence: 99%

Assessment of atrial septal defects rims on transesophageal echocardiogram at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

2017

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“…Deficient aortic rim is a rather common morphologic feature of ASD and is present in up to 30-50% of ASDs that are considered complex [16]. Deficient aortic rim is a risk factor for aortic erosion after device closure of ASDs.…”

Section: Deficient Aortic Rimmentioning

confidence: 99%

Challenges in Atrial Septal Defect Occlusion

Tal¹,

Dotan²,

Schwartz³

et al. 2017

jshd

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We present 11 cases of percutaneous transcatheter occlusion of atrial septal defects (ASDs) in adults, including multi-fenestrated ASD, balloon-assisted deployment of ASD occlude, dilator-assisted deployment of ASD occlude, "cobra"-shaped disfiguration of the left disc, ASD with deficient aortic rim, pulmonary vein-assisted deployment of ASD occlude, "high" ASD, large Chiari network, double interatrial septum, snaring a runaway occluder, and right ventricular diastolic dysfunction causing cyanosis. Each case is followed by a practical discussion of the special dilemmas, complications, and challenges that may occur during common procedures.

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“…The defect morphology determines the indication for transcatheter treatment. In cases of multiple defects, percutaneous device closure is not generally indicated [3] , [4] . We report a case in which a single ostium secundum type ASD masqueraded as multiple defects on color flow imaging due to a refraction artifact.…”

Section: Introductionmentioning

confidence: 99%

A single atrial septal defect masquerading as multiple defects due to a refraction artifact – A cautionary note

Ochi

Yamasaki

Baba

et al. 2020

Journal of Cardiology Cases

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Echocardiography is useful for making a diagnosis of atrial septal defect (ASD) by directly visualizing the shunt flow. Herein, we present a case in which a single ostium secundum type ASD masqueraded as multiple defects on color flow imaging by transthoracic echocardiography. We confirmed by transesophageal echocardiography that this patient actually had a single ASD. An echocardiographic refraction artifact was considered to be the cause of this phenomenon. We need to be aware of the existence of this artifact to avoid misdiagnosis. 〈 Learning objective: Echocardiography is useful for making a diagnosis of atrial septal defect (ASD). We present the case with a single ostium secundum type ASD which masqueraded as multiple defects on color flow imaging due to a refraction artifact. Refraction artifacts can make multiple false flow signals on color imaging. This case emphasizes the importance of an understanding of the existence of this artifact in not only B mode imaging but also color Doppler imaging.〉

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Techniques and outcomes of transcatheter closure of complex atrial septal defects – Single center experience

Abstract: Trans catheter closure is feasible in anatomically complex substrates of Secundum ASD. Careful case selection, scrupulous imaging protocol, and expertise in modified techniques are mandatory for successful outcomes.

Cited by 17 publications

References 8 publications

Assessment of atrial septal defects rims on transesophageal echocardiogram at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Assessment of atrial septal defects rims on transesophageal echocardiogram at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Challenges in Atrial Septal Defect Occlusion

A single atrial septal defect masquerading as multiple defects due to a refraction artifact – A cautionary note

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