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The predictors of dislodgement and outcomes of transcatheter closure of complex atrial septal defects in adolescents and adults
- Source :
- Clinical Trials and Regulatory Science in Cardiology, Vol 11, Iss C, Pp 1-5 (2015)
- Publication Year :
- 2015
- Publisher :
- Elsevier, 2015.
-
Abstract
- Objective Technical difficulties still exist for the catheter closure of atrial septal defects (ASD) in some of the morphological features of defects, or hemodynamic features in the population. The morphological or hemodynamic features are (1) large ASD, (2) wide rim deficiency, (3) multiple defects, (4) severe pulmonary hypertension, (5) ventricular dysfunction, and (6) restrictive left ventricular compliance. Our study aimed to assess the efficacy of transcatheter closure of complex ASDs under transesophageal echocardiography (TEE) guidance in adolescents and adults, and figured out the predictors of atrial septum occluder (ASO) dislodgement. Methods From June 2003 to June 2014, 125 adults and 12 adolescents were diagnosed with secundum ASD and underwent a transcatheter closure of defects using an ASO. Among the above patients, 63 patients had morphological or hemodynamic features that made ASD closure difficult. Results No ASO dislodgement occurred in the non-complex ASD closure group, and an 88.9% success rate was observed in the complex ASD closure group. Higher Qp/Qs ratio, higher incidence of multiple ASDs, and larger ASD size in the complex ASD closure group were noted. 50.8% patients in complex ASD closure group had ASD ≧ 30 mm. Multivariate analysis demonstrated that an occurrence of eroded and IAS or aneurysm formation and arrhythmia during implantation were independent predictors for ASO dislodgement in complex ASD closure (p = 0.005; p = 0.037). Conclusion Eroded and floppy IAS or aneurysm formation post ASO implantation and peri-procedure arrhythmia could predict ASO dislodgement in complex ASD closure. Transcatheter closure of ASDs under TEE guidance is feasible in complex cases.
- Subjects :
- medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
genetic structures
Population
Septum secundum
Atrial septal occluder
Hemodynamics
behavioral disciplines and activities
Atrial septal defects
Internal medicine
mental disorders
medicine
Transcatheter closure
Closure (psychology)
education
education.field_of_study
ASO dislodgement
business.industry
medicine.disease
Pulmonary hypertension
Complex atrial septal defect
Atrial septum
Surgery
Catheter
lcsh:RC666-701
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 24055875
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Clinical Trials and Regulatory Science in Cardiology
- Accession number :
- edsair.doi.dedup.....6fcb3c5598f4ef45f399f188e3681c84