Document Detail


Thoracoscopic ASD closure is a reliable supplement for percutaneous treatment.
MedLine Citation:
PMID:  15894781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the feasibility and effectiveness of endoscopic atrial septal defect (ASD) closure when percutaneous ASD closure is impossible or has failed. PATIENTS: Between March 1997 and February 2003, 74 patients (63% female, mean (SD) age 44 (16) years) underwent an endoscopic ASD closure. Median preoperative New York Heart Association functional class was I. Clinical and echocardiographic follow up was obtained for all patients (mean (SD) 38 (19) months). Patients were assessed for scar aesthetics, procedure related pain, functional recovery, and overall patient satisfaction. RESULTS: ASD closure was successful in all patients (two primum ASD, 68 secundum ASD, four sinus venosus type). Patch repair was performed in 42%. Mean aortic cross clamp and cardiopulmonary bypass times were 54 (24) minutes and 98 (35) minutes, respectively. There were no in-hospital deaths and no conversions to sternotomy. Complications included one iliac vein stenting, one femoral arterioplasty, two revisions for suspected bleeding, and seven cases of atrial fibrillation. Two patients required late reoperation: one for atrial thrombus and another for tricuspid regurgitation. Echocardiographic control confirmed complete ASD closure in 71 patients and a small residual shunt in three patients. Ninety three per cent of the patients were highly satisfied with very low procedure related pain and 97% felt they had an aesthetically pleasing scar. CONCLUSION: Endoscopic ASD closure can be safely done with a high degree of patient satisfaction. It is now the authors' exclusive surgical approach whenever percutaneous treatment is not indicated or has failed.
Authors:
F P Casselman; H Dom; B De Bruyne; Y Vermeulen; H Vanermen
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  91     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-16     Completed Date:  2005-07-07     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  791-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular and Thoracic Surgery, OLV Clinic, Moorselbaan 164, 9300 Aalst, Belgium. filip.casselman@olvz-aalst.be
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Cicatrix / psychology
Feasibility Studies
Female
Heart Septal Defects, Atrial / psychology,  surgery*
Humans
Male
Middle Aged
Pain, Postoperative / etiology
Patient Satisfaction
Postoperative Care / methods
Postoperative Complications / etiology
Recovery of Function
Retrospective Studies
Thoracoscopy / methods*
Comments/Corrections

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


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