1
|
Griesman JD, Marshall AC. Headaches in Children After Transcatheter Device Closure of Atrial Septal Defects: A Single-Centre Experience. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2024; 3:102-106. [PMID: 39070953 PMCID: PMC11282878 DOI: 10.1016/j.cjcpc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/10/2024] [Indexed: 07/30/2024]
Abstract
Background Transcatheter device closure (TDC) is the most common treatment for isolated atrial septal defects in children. In the adult population, the incidence of new-onset migraine headache after TDC is well recognized and is estimated at 15%. New-onset headache after paediatric TDC has not been well described. We reviewed our centre's experience to estimate the rate of headache complaints among paediatric patients after TDC. Methods We performed a single-centre, retrospective review of all children who underwent TDC between January 1, 2018, and December 31, 2021. For the included patients, we comprehensively reviewed the electronic medical record to identify patients reported to experience post-TDC headache. Results A total of 165 consecutive patients underwent TDC during the study period. Of these, 134 met inclusion criteria, and 20 patients (15%) had headache documented in the electronic medical record. Of 20 patients, 4 (20%) had headaches that led to further investigation or changed postprocedural medical management. Two patients had brain magnetic resonance imaging to investigate headaches; both studies were interpreted as nonpathologic. One patient required emergency department management for status migrainosus. A second, with a prior history of migraine, required admission for migraine exacerbation. In addition to those needing symptomatic management, 3 patients had a change in their antiplatelet regimen from aspirin to clopidogrel. Conclusions Our study suggests a minimal estimate of 15% as the incidence of headache in children who undergo TDC. This estimate can inform counselling before TDC. Determination of the true incidence will require focused prospective data collection.
Collapse
Affiliation(s)
- Joshua D. Griesman
- Department of Paediatrics, Division of Cardiology, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Audrey C. Marshall
- Department of Paediatrics, Division of Cardiology, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Koumallos N, Aggeli C, Milas T, Tsioufis K. Late erosion of Amplatzer Septal Occluder device 9 years after the implantation: a case report. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2023; 37:ivad132. [PMID: 37589663 PMCID: PMC10481768 DOI: 10.1093/icvts/ivad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/16/2023] [Indexed: 08/18/2023]
Abstract
Cardiac erosion is a rare but life-threatening complication after the interventional closure of an atrial septal defect. We present the case of a patient who developed cardiac erosion 9 years after the placement of an Amplatzer Septal Occluder. The patient presented to our hospital with symptoms of tamponade. Surgical exploration revealed a tear in the roof of the left atrium. To our knowledge, this is one of the most delayed presentations reported. In these cases, diagnosis is difficult and a level of clinical suspicion is demanded.
Collapse
Affiliation(s)
- Nikolaos Koumallos
- Department of Cardiac Surgery, Hippokration General Hospital, Athens, Greece
| | - Costantina Aggeli
- Cardiology Department, Hippokration General Hospital, Athens, Greece
| | - Theodoros Milas
- Department of Cardiac Surgery, Hippokration General Hospital, Athens, Greece
| | | |
Collapse
|
3
|
Muroke V, Jalanko M, Haukka J, Sinisalo J. Cause-Specific Mortality of Patients With Atrial Septal Defect and Up to 50 Years of Follow-Up. J Am Heart Assoc 2023; 12:e027635. [PMID: 36625312 PMCID: PMC9939073 DOI: 10.1161/jaha.122.027635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background This study aimed to evaluate the long-term mortality and cause-specific mortality of patients with atrial septal defect (ASD) in a nationwide cohort. Methods and Results All patients diagnosed with simple ASD in the hospital discharge registry from 1969 to 2019 were included in the study. Complex congenital defects were excluded. Each subject was matched with 5 controls according to sex, age, and municipality at the index time. Adjusted mortality risk ratios (MRRs) were calculated using Poisson regression models. The median follow-up time was 11.1 years. Patients with ASD had higher overall mortality during follow-up, with an adjusted MRR of 1.72 (95% CI, 1.61-1.83). Patients with closed ASDs also had higher total mortality (MRR, 1.29 [95% CI, 1.10-1.51]). However, no difference in mortality was detected if the defect was closed before the age of 30 (MRR, 1.58 [95% CI, 0.90-2.77]), and transcatheter closed defects had lower mortality than the control cohort (MRR, 0.65 [95% CI, 0.42-0.99]). Patients with ASD had significantly more deaths due to congenital malformations (MRR, 54.61 [95% CI, 34.03-87.64]), other diseases of the circulatory system (MRR, 2.90 [95% CI, 2.42-3.49]), stroke (MRR, 1.89 [95% CI, 1.52-2.33]), diseases of the endocrine (MRR, 1.88 [95% CI, 1.10-3.22]) and respiratory system (MRR, 1.71 [95% CI, 1.19-2.45]), ischemic heart disease (MRR, 1.62 [95% CI, 1.41-1.86]), and accidents (MRR, 1.41 [95% CI, 1.05-1.89]). Conclusions Patients with ASD had higher overall mortality compared with a matched general population cohort. Increased cause-specific mortality was seen in congenital malformations, stroke, and heart diseases.
Collapse
Affiliation(s)
- Valtteri Muroke
- Department of CardiologyHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Mikko Jalanko
- Department of CardiologyHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Jari Haukka
- Department of Public Health, ClinicumUniversity of HelsinkiHelsinkiFinland
| | - Juha Sinisalo
- Department of CardiologyHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| |
Collapse
|
4
|
Pelzek C, Rhinehart J, Villalba M, Schober K, Winter R, Berman D. Transient high-grade second-degree atrioventricular block secondary to transvenous atrial septal defect occlusion in a dog. J Vet Cardiol 2022; 41:30-38. [DOI: 10.1016/j.jvc.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
|
5
|
Edlinger C, Paar V, Kheder SH, Krizanic F, Lalou E, Boxhammer E, Butter C, Dworok V, Bannehr M, Hoppe UC, Kopp K, Lichtenauer M. Endothelialization and Inflammatory Reactions After Intracardiac Device Implantation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1401:1-22. [DOI: 10.1007/5584_2022_712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Scutelnic A, Mattle HP, Branca M, Jung S, Reichlin T, Fischer U, Schankin CJ. Migraine and atrial fibrillation: a systematic review. Eur J Neurol 2021; 29:910-920. [PMID: 34826198 DOI: 10.1111/ene.15198] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Patients with migraine are at increased risk of stroke. The aim was to systematically review the current literature on the association between migraine and atrial fibrillation, which is a relevant risk factor for stroke. METHODS PubMed was searched for 'migraine' AND 'atrial fibrillation' and selected original investigations on the association of migraine and atrial fibrillation for our analysis. Articles without original data, such as guidelines, narrative reviews, editorials and others, were excluded. RESULTS In all, 109 publications were found. Twenty-two were included and analysed for this review. The population-based Atherosclerosis Risk in Communities study showed a significant association of migraine with visual aura and incident atrial fibrillation (hazard ratio 1.30, 95% confidence interval 1.03-1.62, p = 0.02), but not for migraine without aura, compared to non-headache persons after multivariable adjustment for vascular risk factors. An even larger population-based study in Denmark confirmed this association (odds ratio 1.25, 95% confidence interval 1.16-1.36). Studies investigating patients with ischaemic stroke and migraine are methodologically insufficient and provide contradictory results. Ablation therapy for atrial fibrillation in patients with migraine might reduce migraine attacks, but transient post-ablation new-onset migraine-like headaches in persons without a history of migraine have also been reported. CONCLUSION Population-based studies indicate a significant association of migraine with aura and atrial fibrillation. In practical terms, screening for atrial fibrillation in patients who have a long history of migraine might be reasonable, whereas in patients with stroke or other disorders and migraine extensive screening for atrial fibrillation should be performed as in all patients without migraine.
Collapse
Affiliation(s)
- Adrian Scutelnic
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Heinrich P Mattle
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Mattia Branca
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - Simon Jung
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Urs Fischer
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.,Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christoph J Schankin
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| |
Collapse
|
7
|
Randall J, Morgan G, Zablah J. Using the new Amplatzer Trevisio delivery cable to facilitate closure of atrial and ventricular shunts. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2020.101307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
8
|
Panakkal B, Gaidhane P, Prajapati J, Patel I, Bhutada B, Yadav C, Yadav K. Clinical profile of patients of ASD device closure with special reference to short and intermediate term complications. JOURNAL OF THE PRACTICE OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.4103/jpcs.jpcs_30_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
9
|
Khan MA, Korejo H, Sohail A, Shaikh AS, Patel N. Immediate and Short-Term Outcome of Percutaneous Atrial Septal Defects Closure in Adult Patients. Cureus 2020; 12:e11165. [PMID: 33251072 PMCID: PMC7688064 DOI: 10.7759/cureus.11165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Atrial septal defect secundum (ASD II) is the commonest of the congenital heart diseases in the adult population and the closure of ASD II causes a significant improvement in hemodynamics and the clinical status of the patient. However, it carries certain risks, especially the development of post-closure pulmonary edema and congestive cardiac failure, which may lead to death. Therefore, this study was designed to share our experience and to evaluate the immediate and short-term outcomes of percutaneous closure of ASD II in adult patients presenting at a tertiary care cardiac center in Karachi, Pakistan. Methodology In this study, we included 30 adult (≥ 40 years) patients who underwent percutaneous ASD II closure at the pediatric cardiology department of the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan, between June 1, 2017, and July 31, 2019. Data for this study were extracted from a prospectively collected departmental database. Extracted data for this study consisted of demographic profile, comorbid conditions, echocardiographic findings, cardiac catheterization data, pre and post six-month electrocardiographic findings, and New York Heart Association (NYHA) Functional Classification (FC). Results Out of 30 adult patients, 18 (60%) were female. The mean age of the patients at the time of ASD closure was 51.43 ± 7.09 years, ranging between 40 and 67 years. None of the patients had any post-intervention complications. Mean systolic pulmonary artery pressure (SPAP) on cardiac catheterization pre-implantation was 49.8 ± 16.3 mmHg range was 20-90 mmHg while SPAP immediately after device implantation was 37 ± 11.4 range 20 to 65 mmHg with p<0.001. Mean SPAP on pre-catheterization echocardiography was 58.8 ± 14.3, range 30-95 mmHg, while after six months, the mean SPAP was 34.5 ± 7.2, range 20-45 mmHg, with p<0.001 in 28 (93.3%) patients (in two patients, there was no TR). There was no mortality up till six months after the intervention. The functional class (FC) after six months of the procedure improved in most, 90% (27), of the patients. Conclusion There were no complications immediately after the procedure. After six months, post-procedure SPAP decreased to < 50 mmHg in the majority of patients (96.6%). Functional class (FC) improved in most (90%) of the adult (≥ 40 years) patients undergone percutaneous atrial septal defects closure. Therefore, percutaneous closure of ASD II is a safe and effective procedure for adult patients.
Collapse
|
10
|
Risk factors for adverse events within one year after atrial septal closure in children: a retrospective follow-up study. Cardiol Young 2020; 30:303-312. [PMID: 31847927 DOI: 10.1017/s1047951119002919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Secundum atrial septal defect is one of the most common congenital heart defects. Previous paediatric studies have mainly addressed echocardiographic and few clinical factors among children associated with adverse events. The aim of this study was to identify neonatal and other clinical risk factors associated with adverse events up to one year after closure of atrial septal defect. METHODS This retrospective case-control study includes children born in Sweden between 2000 and 2014 that were treated surgically or percutaneously for an atrial septal defect. Conditional logistic regression was used to evaluate the association between major and minor adverse events and potential risk factors, adjusting for confounding factors including prematurity, neonatal sepsis, neonatal general ventilatory support, symptomatic atrial septal defects, and pulmonary hypertension. RESULTS Overall, 396 children with 400 atrial septal defect closures were included. The median body weight at closure was 14.5 (3.5-110) kg, and the median age was 3.0 (0.1-17.8) years. Overall, 110 minor adverse events and 68 major events were recorded in 87 and 49 children, respectively. Only symptomatic atrial septal defects were associated with both minor (odds ratio (OR) = 2.18, confidence interval (CI) 95% 1.05-8.06) and major (OR = 2.80 CI 95% 1.23-6.37) adverse events. CONCLUSION There was no association between the investigated neonatal comorbidities and major or minor events after atrial septal defect closure. Patients with symptomatic atrial septal defects had a two to four times increased risk of having a major event, suggesting careful management and follow-up of these children prior to and after closure.
Collapse
|
11
|
Kitano M, Yazaki S, Sugiyama H, Ohtsuki SI, Tomita H. Risk Factors and Predictors of Cardiac Erosion Discovered from 12 Japanese Patients Who Developed Erosion After Atrial Septal Defect Closure Using Amplatzer Septal Occluder. Pediatr Cardiol 2020; 41:297-308. [PMID: 31732763 DOI: 10.1007/s00246-019-02256-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 11/05/2019] [Indexed: 11/30/2022]
Abstract
Cardiac erosion is a rare serious complication following Amplatzer septal occluder (ASO) placement for atrial septal defect. Although multiple risk factors have been found, a useful predictor to prevent it has not been established yet. In 12 patients who developed erosion between 2005 and 2016 in Japan, we retrospectively observed patients' characteristics and transesophageal echocardiography findings immediately before and after ASO placement and at erosion onset. We compared risk factors of erosion, including absent aortic rim, device size/body weight ratio, device shape, or Valsalva sinus wall deformation pressed by either disk-edge, the maximum depth of which from the standard curve of the Valsalva wall was defined as Dent, between the 12 patients and 95 patients with Valsalva sinus wall deformation immediately after placement who did not develop erosion for 5 ± 3 years. Of the 12 patients, nine developed pericardial effusion with eight cardiac tamponade and three aorta-atrium fistula; all were surgically rescued. Surgical findings revealed that erosion in all patients occurred at the right and/or left atrial roof beside the Valsalva in the non-coronary cusp on which the disk-edge seemed to be pressing. The mean Dent immediately after the placement in patients with erosion was significantly deeper than without (2.48 ± 0.32 vs. 1.28 ± 0.38; p < 0.001). There were no differences in the other risk factors between the two groups. Dent is believed to be a useful indicator of erosion development after ASO placement. If Dent is > 2.0 mm, it is desirable to change the size or to replace the device.
Collapse
Affiliation(s)
- Masataka Kitano
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 6-1, Kishibeshinmachi, Suita City, Osaka Prefecture, 564-8565, Japan.
| | - Satoshi Yazaki
- Department of Pediatric Cardiology, Sakakibara Heart Institute, Fuchu, Tokyo, Japan
| | - Hisashi Sugiyama
- Department of Pediatric Cardiology, Tokyo Women's Medical University Hospital, Shinjuku, Tokyo, Japan
| | - Shin-Ichi Ohtsuki
- Department of Pediatric Cardiology, Okayama University Hospital, Okayama, Okayama, Japan
| | - Hideshi Tomita
- Pediatric Heart Disease & Adult Congenital Heart Disease Center, Showa University Hospital, Shinagawa, Tokyo, Japan
| |
Collapse
|
12
|
Nyboe C, Karunanithi Z, Nielsen-Kudsk JE, Hjortdal VE. Long-term mortality in patients with atrial septal defect: a nationwide cohort-study. Eur Heart J 2019; 39:993-998. [PMID: 29211856 PMCID: PMC6037065 DOI: 10.1093/eurheartj/ehx687] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 11/08/2017] [Indexed: 11/29/2022] Open
Abstract
Aims In this nationwide cohort of atrial septal defect (ASD) patients, the largest to date, we report the longest follow-up time with and without closure in childhood and adulthood compared with a general population cohort. Methods and results Using population-based registries, we included Danish individuals born before 1994 who received an ASD diagnosis between 1959 and 2013. All diagnoses were subsequently validated (n = 2277). Using the Kaplan–Meier estimates and Cox proportional hazards regression adjusted for sex, birth year, and a modified Charlson Comorbidity Index, we compared the mortality of ASD patients with that of a birth year and sex matched general population cohort. The median follow-up from ASD diagnosis was 18.1 years (range 1–53 years). Patients with ASD had a higher mortality [adjusted hazard ratio (HR): 1.7; 95% confidence interval (CI): 1.5–1.9] compared with the general population cohort. The adjusted HR 30 days after closure was 1.4 (95% CI: 1.2–1.7), and it was 2.4 (95% CI: 2.0–2.9) for patients without closure. Conclusion Overall, ASD patients had a higher long-term mortality than a general population cohort matched on birth year and gender. Our data indicate a lower relative mortality of those ASD patients undergoing closure than the ASD patients not undergoing closure.
Collapse
Affiliation(s)
- Camilla Nyboe
- Department of Cardiothoracic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Zarmiga Karunanithi
- Department of Cardiothoracic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Jens Erik Nielsen-Kudsk
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Vibeke E Hjortdal
- Department of Cardiothoracic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| |
Collapse
|
13
|
Onakatomi Y, Asou T, Takeda Y, Ueda H, Goda M, Masuda M. Aortic erosion occurring in over 5 years after Amplatzer septal Occluder implantation for secundum atrial septal defect: a case report. J Cardiothorac Surg 2019; 14:159. [PMID: 31492164 PMCID: PMC6728993 DOI: 10.1186/s13019-019-0982-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Aortic erosion is a serious complication that usually occurs shortly after Amplazter Septal Occluder (ASO) implantation for atrial septal defect (ASD). Case presentation A seven-year-old girl was diagnosed with secundum ASD without symptoms. Transesophageal echocardiography (TEE) showed a defect of 20 mm in diameter in the fossa ovalis without aortic rim. An ASO device of 24 mm in diameter was selected and electively implanted. The “A-shape” of the device was confirmed by intraoperative TEE, a landmark finding indicating the proper implantation of ASO in patients without aortic rim. After an uneventful postoperative course of 5 years and 10 months, she was transferred to our unit due to cardiogenic shock. Her echocardiogram in emergency room showed pericardial effusion with collapsed right ventricle. Given her history of ASO and the observation of the sequentially increasing pericardial effusion, we diagnosed her with acute cardiac tamponade due to aortic erosion. Emergency pericardiotomy was then performed to improve the hemodynamic condition. Fresh clots were found, so we immediately prepared the cardiopulmonary bypass circuit and explored the damage to the aorta, in which the clots had accumulated. Bleeding suddenly started when the clots were removed. We then inserted the cannulae for perfusion and venous drainage. The clots were removed, and tears were found in both the lateral side of the ascending aorta and the right atrial wall. Intraoperative TEE showed that an edge of the ASO device was directly touching the aortic wall and the Doppler color-flow imaging showed blood flow through this lesion. The erosive lacerations of both the ascending aorta and right atrium were detected from the inside after achieving cardioplegic cardiac arrest. The ascending aorta was obliquely incised, and the laceration was closed from inside the aortic root. The postoperative course was uneventful. She has been doing well for 5 years since the surgery. Conclusions We experienced and successfully treated a rare case of acute cardiac tamponade caused by aortic erosion 5 years and 10 months after ASO implantation.
Collapse
Affiliation(s)
- Yasuko Onakatomi
- Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Toshihide Asou
- Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yuko Takeda
- Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hideaki Ueda
- Department of Cardiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Motohiko Goda
- Department of Cardiovascular Surgery, Yokohama City University, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-0008, Japan.
| | - Munekata Masuda
- Department of Cardiovascular Surgery, Yokohama City University, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-0008, Japan
| |
Collapse
|
14
|
Abe T, Tsukano S, Tosaka Y. Pericardial tamponade due to erosion of a Figulla Flex II device after closure of an atrial septal defect. Catheter Cardiovasc Interv 2019; 94:1003-1005. [DOI: 10.1002/ccd.28367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/03/2019] [Accepted: 05/28/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Tadaaki Abe
- Department of PediatricsNiigata University School of Medicine Niigata Japan
| | - Shinya Tsukano
- Department of PediatricsNiigata City General Hospital Niigata Japan
| | - Yuko Tosaka
- Department of Cardiovascular SurgeryNiigata City General Hospital Niigata Japan
| |
Collapse
|
15
|
Adverse events within 1 year after surgical and percutaneous closure of atrial septal defects in preterm children. Cardiol Young 2019; 29:626-636. [PMID: 31159892 DOI: 10.1017/s1047951119000350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Atrial septal defect is the third most common CHD. A hemodynamically significant atrial septal defect causes volume overload of the right side of the heart. Preterm children may suffer from both pulmonary and cardiac comorbidities, including altered myocardial function. The aim of this study was to compare the rate of adverse events following atrial septal defect closure in preterm- and term-born children. METHOD We performed a retrospective cohort study including children born in Sweden, who had a surgical or percutaneous atrial septal defect closure at the children's hospitals in Lund and Stockholm, between 2000 and 2014, assessing time to the first event within 1 month or 1 year. We analysed differences in the number of and the time to events between the preterm and term cohort using the Kaplan-Meier survival curve, a generalised model applying zero-inflated Poisson distribution and Gary-Anderson's method. RESULTS Overall, 413 children were included in the study. Of these, 93 (22.5%) were born prematurely. The total number of adverse events was 178 (110 minor and 68 major). There was no difference between the cohorts in the number of events, whether within 1 month or within a year, between major (p = 0.69) and minor (p = 0.84) events or frequencies of multiple events (p = 0.92). CONCLUSION Despite earlier procedural age, larger atrial septal defects, and higher comorbidity than term children, preterm children appear to have comparable risk for complications during the first year after surgical or percutaneous closure.
Collapse
|
16
|
Long term evaluation of electromechanical delay in patients with atrial septal defect after transcatheter closure. Int J Cardiovasc Imaging 2018; 35:33-39. [PMID: 30062536 DOI: 10.1007/s10554-018-1426-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
Some studies have been showed that electromechanical delay, which may pose an increased tendency to atrial fibrillation, may prolong in patients with various clinical conditions. In addition, the electromechanical delay in patients with secundum type atrial septal defect (ASD) compared to healthy people have been reported previously. Therefore, in the present study, we prospectively evaluated the mid-term and long-term effects of the transcatheter closure of secundum type ASD on the lateral atrial conduction time (PA), septal PA, tricuspid PA, left and right intra-atrial electromechanical delay (ILeft-EMD and IRight-EMD, respectively) and inter-atrial electromechanical delay (IA-EMD) measured by means of Doppler echocardiography. Our prospective study included a total of 45 secundum type ASD patients who undergone percutaneous transcatheter closure from December 2012 to April 2015. All patients underwent transthoracic echocardiography (TTE) before the closure, at sixth and twelfth months after the closure. In comparison of the EMD sixth months after the device closure, there were statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to pre-device closure values. Twelfth months after the device closure, we also observed statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to 6-month post-device closure values. In the present study, we observed that the atrial EMD improves after device closure and continues to improve after twelfth month following post-device closure.
Collapse
|
17
|
Jalal Z, Hascoet S, Baruteau AE, Iriart X, Kreitmann B, Boudjemline Y, Thambo JB. Long-term Complications After Transcatheter Atrial Septal Defect Closure: A Review of the Medical Literature. Can J Cardiol 2016; 32:1315.e11-1315.e18. [DOI: 10.1016/j.cjca.2016.02.068] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/19/2016] [Accepted: 02/26/2016] [Indexed: 11/30/2022] Open
|
18
|
Amedro P, Soulatges C, Fraisse A. Infective endocarditis after device closure of atrial septal defects: Case report and review of the literature. Catheter Cardiovasc Interv 2016; 89:324-334. [PMID: 27641431 DOI: 10.1002/ccd.26784] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 08/15/2016] [Indexed: 11/08/2022]
Abstract
We report a case of late infective endocarditis in an 8-year-old boy 3 years after transcatheter closure of an atrial septal defect with the Amplatzer Atrial Septal Occluder Device. Echocardiography showed a very thick pannus lining the left atrial disc of the prosthesis, with some mobile elements. MRI showed several cerebral microemboli. The patient had dental caries and blood cultures found Staphylococcus aureus. Patient was treated with gentamicin and oxacillin before surgical removal of the prosthesis. Twenty-one cases of infective endocarditis after atrial defect device closure have been reported in the literature (13 ostium secundum ASD and 8 patent foramen ovale). Seven pediatric cases were reported. S. aureus was the most frequent bacterium. Antibiotics were administered in all cases and most patients (n = 18) underwent surgical removal of the device. Incomplete endothelialization of the prosthesis was a suggested mechanism. Two patients died after surgery. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Pascal Amedro
- Pediatric and Congenital Cardiology Department, M3C Regional Center, University Hospital, Montpellier, France.,Physiology and Experimental Biology of Heart and Muscles Laboratory - PHYMEDEXP, UMR CNRS 9214 - INSERM U1046, Montpellier, France
| | - Camille Soulatges
- Pediatric and Congenital Cardiology Department, M3C Regional Center, University Hospital, Montpellier, France
| | - Alain Fraisse
- Pediatric Cardiology Service, Royal Brompton and Harefield Hospital Trust, London, United Kingdom
| |
Collapse
|
19
|
Zdradzinski MJ, Elkin RL, Lee JM, Qureshi AM, El-Mallah W, Krasuski RA. Contributors to and impact of residual shunting after device closure of atrial septal defects. Am Heart J 2016; 177:112-9. [PMID: 27297856 DOI: 10.1016/j.ahj.2016.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 03/30/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of residual shunt in patients after device closure of atrial septal defect and its impact on long-term outcome has not been previously defined. METHODS From a prospective, single-institution registry of 408 patients, we selected individuals with agitated saline studies performed 1 year after closure. Baseline echocardiographic, invasive hemodynamic, and comorbidity data were compared to identify contributors to residual shunt. Survival was determined by review of the medical records and the Social Security Death Index. Survival analysis according to shunt included construction of Kaplan-Meier curves and Cox proportional hazards modeling. RESULTS Among 213 analyzed patients, 27% were men and age at repair was 47 ± 17 years. Thirty patients (14%) had residual shunt at 1 year. Residual shunt was more common with Helex (22%) and CardioSEAL/STARFlex (40%) occluder devices than Amplatzer devices (9%; P = .005). Residual shunts were more common in whites (79% vs 46%, P = .004). At 7.3 ± 3.3 years of follow-up, 13 (6%) of patients had died, including 8 (5%) with Amplatzer, 5 (25%) with CardioSEAL/STARFlex, and 0 with Helex devices. Patients with residual shunting had a higher hazard of death (20% vs 4%, P = .001; hazard ratio 4.95 [1.59-14.90]). In an exploratory multivariable analysis, residual shunting, age, hypertension, coronary artery disease, and diastolic dysfunction were associated with death. CONCLUSIONS Residual shunt after atrial septal defect device closure is common and adversely impacts long-term survival.
Collapse
Affiliation(s)
- Michael J Zdradzinski
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH
| | - Rachel L Elkin
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH
| | - Joanne M Lee
- Cardiovascular Medicine, Cleveland Clinic's Heart and Vascular Institute, Cleveland, OH
| | - Athar M Qureshi
- Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX
| | - Wael El-Mallah
- Cardiovascular Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Richard A Krasuski
- Cardiology Division, Duke University Health System/Duke University School of Medicine, Durham, NC.
| |
Collapse
|
20
|
Nguyen AK, Palafox BA, Starr JP, Gates RN, Berdjis F. Endocarditis and Incomplete Endothelialization 12 Years after Amplatzer Septal Occluder Deployment. Tex Heart Inst J 2016; 43:227-31. [PMID: 27303238 PMCID: PMC4894701 DOI: 10.14503/thij-14-4949] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A 4-year-old boy had a 15-mm atrial septal defect repaired percutaneously with use of an Amplatzer Septal Occluder. At age 16 years, he presented with a week's history of fever, chills, dyspnea, fatigue, and malaise. Cultures grew methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram showed a 1.25 × 1.5-cm pedunculated mass on the left aspect of the atrial septum just superior to the mitral valve, and a smaller vegetation on the right inferior medial aspect of the septum. At surgery, visual examination of both sides of the septum revealed granulation tissue, the pedunculated mass, the small vegetation, and exposed metal wires that suggested incomplete endothelialization of the occluder. We removed the occluder and patched the septal defect. The patient returned to full activity after 4 months and was asymptomatic 3 years postoperatively. Our report reinforces the need for further investigation into prosthetic device endothelialization, endocarditis prophylaxis, and recommended levels of physical activity in patients whose devices might be incompletely endothelialized. In addition to reporting our patient's case, we review the medical literature on this topic.
Collapse
Affiliation(s)
| | - Brian A. Palafox
- Address for reprints: Brian A. Palafox, MD, Suite 503, 1310 W. Stewart Dr., Orange, CA 92868, E-mail:
| | | | | | | |
Collapse
|
21
|
Sadiq M, Ur Rehman A, Mehmood A. Successful retrieval of a Figulla Occlutech septal occluder - embolized device stability and potential solutions. Ann Pediatr Cardiol 2016; 9:161-3. [PMID: 27212852 PMCID: PMC4867802 DOI: 10.4103/0974-2069.180672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Go to: We report a case of an atrial septal defect where a Figulla Occlutech device embolized into the right ventricle. As this device has no left atrial hub, we brought the bare device into the inferior vena cava and used a novel two-snare technique to slenderize the device into the sheath. This report highlights additional tips in transcatheter device retrieval.
Collapse
Affiliation(s)
- Masood Sadiq
- Department of paediatric cardiology, The Children's Hospital and Punjab Institute of Cardiology, Lahore, Pakistan
| | - Asif Ur Rehman
- Department of paediatric cardiology, The Children's Hospital and Punjab Institute of Cardiology, Lahore, Pakistan
| | | |
Collapse
|
22
|
Relative Risk Factors for Cardiac Erosion Following Transcatheter Closure of Atrial Septal Defects. Circulation 2016; 133:1738-46. [DOI: 10.1161/circulationaha.115.019987] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 03/14/2016] [Indexed: 11/16/2022]
|
23
|
Rahkonen OP, Lee KJ, Chaturvedi RC, Benson LN. The First Ten of Everything: A Review of Past and Current Practice in Pediatric Cardiac Percutaneous Interventions. CONGENIT HEART DIS 2015; 10:292-301. [PMID: 25597863 DOI: 10.1111/chd.12247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study was designed to compare outcomes of the most common pediatric cardiac interventions from the time of implementation with the current era. BACKGROUND Since the introduction of semilunar valve balloon dilation and device closure of the arterial duct and septal defects, development of interventional techniques and devices has been rapid. However, few studies have compared outcomes between those initial interventions and those in the current era. METHODS Five validated common catheter-based therapies were chosen for analysis, including atrial and duct device closure, balloon dilation of the aortic and pulmonary valves, and native coarctation of the aorta. A retrospective review of the first and most recent 10 consecutive patients in each group was performed. RESULTS There was a high mortality (30%) among neonates who underwent aortic valve (AV) dilation in the early era, but no mortality noted in other groups. In the early era, transcatheter atrial defect closure and AV dilations were associated with a low success rate (60% for both lesions) and a high complication rate (40% for atrial septal defect, 30% for AV dilations). Among the last 10 children, the atrial defect occlusion was successful in 100% without complications and AV dilations where successful in all children with a 30% complication rate (one major, two minor). CONCLUSIONS A learning curve with device development plays a significant role in the evolution of transcatheter techniques. These data provide baseline estimates of success and may be used as a template in the future when new techniques are adapted into practice.
Collapse
Affiliation(s)
- Otto P Rahkonen
- The Department of Pediatrics, Division of Cardiology, The Labatt Family Heart Centre, The Cardiac Diagnostic and Interventional Unit, The Hospital for Sick Children, The University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Kyong-Jin Lee
- The Department of Pediatrics, Division of Cardiology, The Labatt Family Heart Centre, The Cardiac Diagnostic and Interventional Unit, The Hospital for Sick Children, The University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Rajiv C Chaturvedi
- The Department of Pediatrics, Division of Cardiology, The Labatt Family Heart Centre, The Cardiac Diagnostic and Interventional Unit, The Hospital for Sick Children, The University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Lee N Benson
- The Department of Pediatrics, Division of Cardiology, The Labatt Family Heart Centre, The Cardiac Diagnostic and Interventional Unit, The Hospital for Sick Children, The University of Toronto School of Medicine, Toronto, Ontario, Canada
| |
Collapse
|
24
|
Mirzada N, Ladenvall P, Johansson MC. Absence of significant aortic regurgitation seven years after closure of patent foramen ovale. INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VESSELS 2014; 4:59-62. [PMID: 29450184 PMCID: PMC5801459 DOI: 10.1016/j.ijchv.2014.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 06/08/2014] [Accepted: 06/24/2014] [Indexed: 11/14/2022]
Abstract
Background It has been suggested that there is an increase in aortic regurgitation (AR) in the short and medium term after percutaneous closure of patent foramen ovale (PFO). The aim of this study is to determine the long-term effect of percutaneous closure of PFO on the prevalence of AR. Methods Patients with cryptogenic stroke or transient ischemic attack who had undergone percutaneous closure of PFO more than five years before the study were invited to an echocardiographic examination. Results Out of 83 invited patients, 64 accepted the invitation and were examined with echocardiography. Mild AR was found in one patient (2%), but this was already evident in the patient's echocardiographic result before PFO closure. Trace AR was detected in 11 patients (17%). No case of moderate or severe AR was detected. Patients with AR were more often hypertensive (six out of 12 patients with AR, compared to nine of the 52 without AR, p = 0.025), and the indexed sinus of Valsalva was larger in patients with AR (18.6 mm/m2, SD 1.6, as compared to 17.3 mm/m2, SD 1.6, p = 0.02). Conclusion In this long-term study with a minimum follow-up of 5.6 years and a mean of 7.1 years, we found negligible levels of AR. Where present, AR was associated with hypertension and mild dilatation of the aortic root, but there was no indication that device closure per se increased the risk of developing AR.
Collapse
Affiliation(s)
- Naqibullah Mirzada
- Institute of Medicine, Department of Molecular and Clinical Medicine, Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Per Ladenvall
- Institute of Medicine, Department of Molecular and Clinical Medicine, Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Magnus C Johansson
- Institute of Medicine, Department of Molecular and Clinical Medicine, Clinical Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| |
Collapse
|
25
|
Abstract
Atrial septal defects are the third most common type of congenital heart disease. Included in this group of malformations are several types of atrial communications that allow shunting of blood between the systemic and the pulmonary circulations. Most children with isolated atrial septal defects are free of symptoms, but the rates of exercise intolerance, atrial tachyarrhythmias, right ventricular dysfunction, and pulmonary hypertension increase with advancing age and life expectancy is reduced in adults with untreated defects. The risk of development of pulmonary vascular disease, a potentially lethal complication, is higher in female patients and in older adults with untreated defects. Surgical closure is safe and effective and when done before age 25 years is associated with normal life expectancy. Transcatheter closure offers a less invasive alternative for patients with a secundum defect who fulfil anatomical and size criteria. In this Seminar we review the causes, anatomy, pathophysiology, treatment, and outcomes of atrial septal defects in children and adult patients in whom this defect is the primary cardiac anomaly.
Collapse
Affiliation(s)
- Tal Geva
- Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Jose D Martins
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Rachel M Wald
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
26
|
Wang Y, Hua Y, Li L, Wang X, Qiao L, Shi X, Hua J, Qu Y, Mu D. Risk factors and prognosis of atrioventricular block after atrial septum defect closure using the Amplatzer device. Pediatr Cardiol 2014; 35:550-5. [PMID: 24169859 DOI: 10.1007/s00246-013-0822-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/03/2013] [Indexed: 11/28/2022]
Abstract
Amplatzer septal occluder (ASO)-induced complications have been observed. However, little attention is paid to the atrioventricular block (AVB) induced by atrial septum defect (ASD) closure using the Amplatzer device. This study aimed to analyze the risk factors and prognosis of AVB after catheter closure and to reduce the incidence of adverse events. In this study, 706 ASD patients who received closure in our division were investigated retrospectively for the relationship between AVB and factors such as age, size of the ASD (D(d)), diameter of the occluder (D(o)), diameter of the septum (D(s)), D(o)/D(d) ratio, and D(o)/D(s) ratio. Data distribution was evaluated with the Kolmogorov-Smirnov normality test. The Wilcoxon rank sum test was used to compare non-normal distribution data. A p value lower than 0.05 was considered significant. Of the 706 patients, six had experienced the development of AVB, giving an incidence of 0.85%. The risk factors included younger age, larger size of the ASD, larger size of the device, and the D(o)/D(s) ratio (≥0.45). The milder AVB is, the better the prognosis. An AVB of III° and an unchanged electrocardiogram (ECG) within 3 days after the procedure are poor prognostic indicators. More attention should be paid to AVB induced by ASD closure. Younger age, size of the ASD, size of the device, and a D(o)/D(s) ratio of 0.45 or higher are the risk factors associated with AVB after closure. A timely retrieval of the device should be considered for a good prognosis.
Collapse
Affiliation(s)
- Yibin Wang
- Division of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Szechuan, China
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Loar RW, Johnson JN, Cabalka AK, Cetta F, Hagler DJ, Eidem BW, Taggart NW. Effect of percutaneous atrial septal defect and patent foramen ovale device closure on degree of aortic regurgitation. Catheter Cardiovasc Interv 2013; 81:1234-7. [DOI: 10.1002/ccd.24779] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 11/16/2012] [Accepted: 12/06/2012] [Indexed: 11/12/2022]
Affiliation(s)
- Robert W. Loar
- Department of Pediatrics; Mayo Clinic; Rochester; Minnesota
| | - Jonathan N. Johnson
- Department of Pediatrics/Division of Pediatric Cardiology; Mayo Clinic; Rochester; Minnesota
| | - Allison K. Cabalka
- Department of Pediatrics/Division of Pediatric Cardiology; Mayo Clinic; Rochester; Minnesota
| | | | | | | | - Nathaniel W. Taggart
- Department of Pediatrics/Division of Pediatric Cardiology; Mayo Clinic; Rochester; Minnesota
| |
Collapse
|
28
|
Abstract
Ostium secundum-type atrial septal defect closure has evolved from a surgical procedure requiring cardiopulmonary bypass to a percutaneous, catheter-based procedure usually requiring only an overnight hospital stay. The overall safety and effectiveness has compared favorably with surgical repair. Although rare, complications have been described, including erosion, device embolization, or malfunction and arrhythmias. The overall long-term clinical outcomes have been excellent: good quality of life, functional class improvement, and ventricular remodeling have been the rule after the procedure. It is mandatory to recommend indefinite follow-up of patients undergoing this procedure for potential long-term complications.
Collapse
Affiliation(s)
- Alejandro Román Peirone
- Pediatric Cardiology Section, Hospital Privado de Córdoba, Naciones Unidas 346, Córdoba 5016, Argentina.
| | - Simone Fontes Pedra
- Echocardiography Laboratory for Congenital Heart Disease, Instituto Dante Pazzanese de Cardiología, Av Dr Dante Pazzanese 500 CEP 04012-180, Sao Paulo, Brazil
| | - Carlos Augusto Cardoso Pedra
- Catheterization Laboratory for Congenital Heart Disease, Instituto Dante Pazzanese de Cardiología, Avenida Doutor Dante Pazzanese 500 CEP 04012-180, Sao Paulo, Brazil; Catheterization Laboratory for Congenital Heart Disease, Hospital do Coração, Sao Paulo, Brazil
| |
Collapse
|