Document Detail


Transcatheter closure of secundum atrial septal defects with complex anatomy.
MedLine Citation:
PMID:  15152159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to evaluate the feasibility, safety and efficacy of transcatheter closure of secundum atrial septal defects (ASD) in patients with complex anatomy. From September 1997 to July 2003, a total of 40 patients (median age, 34 years; 65% female) with complex ASDs, defined as the presence of a large defect (stretched diameter >26 mm) associated with a deficient rim (n=23); multiple defects (n=8); a multi-fenestrated septum (n=5); and defects associated with an aneurysmal septum irrespective of their size (n=4) underwent closure. The Helex device was used in 4 patients and the Amplatzer in the remaining. Two devices were implanted in 2 patients each. Implantation was unsuccessful in 5 patients, with 4 having large defects associated with a deficient anterior rim and a floppy posterior septum. Occlusion was observed in 22 of 35 patients (63%) immediately after implantation and in 31 (89%) at a mean follow-up of 18+/-9 months. No major complications occurred. Right ventricular end-diastolic dimensions (indexed for body surface area) decreased from 135+/-25% before closure to 124+/-15% 24 hours after closure, and to 92+/-12% after 12 months. Two patients with 2 distant defects and 2 patients with large defects remained with shunts (<4 mm) at the latest visit. Transcatheter closure of complex secundum ASDs was feasible, safe and effective; however, large defects associated with a deficient anterior rim and a floppy posterior septum may not be suitable for this approach.
Authors:
Carlos A C Pedra; Simone R F Pedra; César A Esteves; Renata Cassar; Sérgio C Pontes; Sérgio L N Braga; Valmir F Fontes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  16     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-05-20     Completed Date:  2004-07-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  117-22     Citation Subset:  IM    
Affiliation:
Instituto Dante Pazzanese de Cardiologia, Av Dr Dante Pazzanese 500, CEP 04012-180, Sao Paulo, SP, Brazil. cacpedra@uol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Balloon Occlusion / instrumentation*
Blood Vessel Prosthesis Implantation / instrumentation,  methods*
Child
Contrast Media
Echocardiography, Transesophageal
Feasibility Studies
Female
Follow-Up Studies
Heart Catheterization / methods
Heart Septal Defects, Atrial / pathology,  surgery*,  ultrasonography
Humans
Male
Middle Aged
Safety
Surgical Instruments
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
J Invasive Cardiol. 2004 Mar;16(3):123-5   [PMID:  15152160 ]

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


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