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Device closure of diverse layout of multi-hole secundum atrial septal defect: different techniques and long-term

Zeeshan Farhaj1, Li Hongxin2, Guo Wenbin3

  • 1Department of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong University, No 324 Jingwu Road, Jinan, 250021, China.

Journal of Cardiothoracic Surgery
|July 6, 2019
PubMed

Insights

This study introduces a new classification for multi-hole secundum atrial septal defects (MHASD) to guide tailored occlusion techniques. The classification improved procedural efficiency and successful closure rates for these complex heart defects.

Area of Science:

  • Cardiology
  • Medical Devices
  • Surgical Techniques

Background:

  • Standardized classifications and occlusion techniques for multi-hole secundum atrial septal defects (MHASD) lack consensus.
  • MHASDs present with variable cribriform or isolated layouts and inter-defects distances.

Purpose of the Study:

  • To present an experience-based classification for MHASDs.
  • To evaluate the outcomes of two distinct occlusion approaches based on this new classification.

Main Methods:

  • Retrospective analysis of 150 MHASD patients from 1320 undergoing atrial septal defect occlusion.
  • Categorization of MHASDs into four types (A, B, C, D) for guided occlusion via transesophageal echocardiography.
  • Comparison of peratrial (n=122) and percutaneous (n=28) approaches, with specific device strategies for each type.

Main Results:

  • Successful occlusion achieved in all 150 patients.
  • Single-device occlusion was more frequent in Type A, while double-device was more applicable to Type B (p<0.01).
  • Patent foramen ovale devices were effective for Type C and D. Procedural times were shorter for Type A and peratrial approaches.

Conclusions:

  • A novel MHASD classification aids in selecting appropriate techniques and devices.
  • This approach facilitates better occlusion outcomes for complex atrial septal defects.
Abstract

Keywords:
Atrial septal defectClassificationDevice closureMinimally invasive surgeryPeratrial

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