Document Detail


Long-term follow up of secundum atrial septal defect closure with the amplatzer septal occluder.
MedLine Citation:
PMID:  20136855     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: During the past 15 years, closure of a secundum atrial septal defect (ASD) has moved from a surgical to a percutaneous transcatheter approach. Few long-term studies of the efficacy and safety of closure of an ASD by an Amplatzer septal occluder (ASO) exist.
METHODS: To examine the long-term results of secundum ASD closure using the ASO, data on 94 patients who underwent secundum ASD closure with the ASO between 1998 and 2002 were available and reviewed. Data regarding residual shunt, chest pain, palpitations, arrhythmias, headaches, transient ischemic attacks, cerebrovascular accidents, and mortality were collected.
RESULTS: Seven (7.4%) subjects had residual shunts immediately following ASO placement. During follow-up, 4 residual shunts closed for a complete closure rate of 97%. Eighteen (19%) patients reported chest pain during the follow-up period. Twenty-three patients (24%) reported palpitations during the follow up period, 7 were documented arrhythmias, including supraventricular tachycardia, atrial fibrillation, and premature ventricular beats. Migraine headaches were new-onset in 4 patients. Migraine cessation occurred in 2 patients after secundum ASD closure. One child died from a cerebral vascular event 18 months following device placement. Only 1 patient developed mild aortic insufficiency.
CONCLUSION: These data indicate that for up to 120 months of patient follow-up, the ASO continues to be a safe device. Residual shunts and arrhythmias have low incidence post-ASO placement. Given the mortality in one high-risk patient, further investigation into anti-platelet therapy after device placement is warranted.
Authors:
Marc D Knepp; Albert P Rocchini; Thomas R Lloyd; Ranjit M Aiyagari
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  5     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-04-22     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  32-7     Citation Subset:  IM    
Affiliation:
University of Michigan Congenital Heart Center-Department of Pediatrics, Ann Arbor, MI 48109, USA. mknepp@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / etiology
Chest Pain / etiology
Child
Child, Preschool
Headache / etiology
Heart Catheterization / adverse effects,  instrumentation*,  mortality
Heart Septal Defects, Atrial / mortality,  therapy*
Humans
Middle Aged
Retrospective Studies
Septal Occluder Device*
Stroke / etiology
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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