[Percutaneous transcatheter closure for secundum atrial septal defect]
Xiang-qian Shen1, Sheng-hua Zhou, Mei Gao
1Department of Cardiology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Insights
Transcatheter closure is a safe and effective treatment for most patients with atrial septal defects (ASD). This minimally invasive procedure resulted in significant reductions in heart chamber sizes and few complications.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Atrial septal defect (ASD) is a common congenital heart condition.
- Transcatheter closure offers a less invasive alternative to surgical repair.
Purpose of the Study:
- To evaluate the efficacy and safety of transcatheter closure for secundum atrial septal defects (ASD).
Main Methods:
- ASD diagnosis confirmed via transthoracic echocardiogram (TTE) and cardiac catheterization.
- Measurement of ASD diameter using a balloon catheter.
- Deployment of an auto-expanded atrial septal occluder (ASO) under fluoroscopic and TTE guidance.
Main Results:
- Successful closure in 87.5% of 32 patients treated between May 1999 and July 2002.
- Significant reduction in right atrium and right ventricle diameters post-procedure (P < 0.001).
- 12.5% failure rate due to issues with device sizing or dislodgement; no other complications reported.
Conclusions:
- Transcatheter closure is a suitable, safe, and minimally invasive option for the majority of ASD patients.
- The procedure demonstrates a favorable safety profile with a low complication rate.
Objective:
To evaluate the effect of transcatheter closure treatment for secundum atrial septal defect(ASD).
Methods:
ASD was established by transthoracic echocardiogram (TTE) and transvenous cardiac catheterization. A balloon catheter was inserted at ASD and was inflated to measure the ASD stretched diameter. Then, a long sheath was inserted to the left atrium (LA) from the right atrium( RA), Thereafter a proper auto-expanded atrial septal occluder (ASO) was inserted to the tip of the sheath. Under the fluoroscopic and TTE guidance, the ASO was expanded. Once the position of ASO was optimal, it was released.
Results:
From May 1999 to July 2002, 32 patients were treated with this method. Among them, 28 patients (87.5%) obtained satisfactory results. At the end of the operation, TTE could not find out any residual shunt. Before discharging the patients, TTE showed the diameter of the right atrium and the right ventricle were decreased from (39.4 +/- 5.8) mm to (33.7 +/- 4.2) mm and from (45.3 +/- 6.8) mm to (37.1 +/- 4.5) mm respectively (P < 0.001 for both). The operation failed in 4 patients (12.5%). Two patients did not get proper ASO for them in the early period of our work. ASO slipped off from the defects in another 2 patients during the operation. There were no other complications.
Conclusion:
Tanscatheter closure is suitable for most patients with ASD. It is safe and less invasive with few complications.
