Korean Circ J.  2019 Oct;49(10):975-986. 10.4070/kcj.2018.0391.

Procedural, Early and Long-term Outcomes after Percutaneous Closure of Atrial Septal Defect: Comparison between Large and Very Large Atrial Septal Defect Groups

Affiliations
  • 1Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. cjy0122@yuhs.ac

Abstract

BACKGROUND
This study aimed to compare procedural, early and long-term outcome of device closure of atrial septal defect (ASD) between large ASD patients and very large ASD patients.
METHODS
We carried a retrospective study of adult large ASD (defined as ≥25 mm) treated by percutaneous closure using Amplatzer septal occluder during 12-year period (May 2003-February 2015) at a single tertiary center. A total of 269 patients were divided into 2 groups, according to the pre-procedural maximal ASD diameter; 25 mm≤ASD<35mm, group 1 (n=216) and 35 mm≤ASD, group 2 (n=53). We compared procedural parameters, early complications and long-term follow-up results between 2 groups.
RESULTS
The need of modified implantation techniques (MITs) was higher group 2 (23.6% vs. 37.7%, p=0.034). Procedural success rate was considerably high in both groups (99.1% in group 1 vs. 100% in group 2, p=0.620). Major complications were occurred in 4 (1.5%) patients (1.4% vs. 1.9%, p=0.804). Minor complication rate was not different between 2 groups. During long-term follow-up (47.2±32.0 months, range, 6.0-135.5), there was one major complication (0.4%) of stroke. Most common long-term minor event was migraine headache (3.9%) followed by arrhythmias (1.9%) without statistical difference between 2 groups.
CONCLUSIONS
Although MIT was more frequently required in very large ASD groups, the procedural, early and long-term outcomes after percutaneous ASD closure were similar in both groups. This suggested that percutaneous ASD closure for very large ASD could be considered a good treatment option.

Keyword

Atrial septal defect; Septal occluder; Cardiac catheterization; Clinical outcomes

MeSH Terms

Adult
Arrhythmias, Cardiac
Cardiac Catheterization
Follow-Up Studies
Heart Septal Defects, Atrial*
Humans
Migraine Disorders
Retrospective Studies
Septal Occluder Device
Stroke

Figure

  • Figure 1 The fates of TR before procedure and at last follow-up. TR = tricuspid regurgitation.


Cited by  3 articles

Procedural, Early and Long-Term Outcomes after Transcatheter Atrial Septal Defects Closure: Comparison between Large and Very Large Atrial Septal Defect Groups
So-Ick Jang
Korean Circ J. 2019;49(10):987-989.    doi: 10.4070/kcj.2019.0165.

The Use of Diuretics on Atrial Septal Defect: To Use or Not to Use
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Korean Circ J. 2021;51(12):1030-1032.    doi: 10.4070/kcj.2021.0351.

Association between the Use of Diuretics and Size Reduction in Pediatric Atrial Septal Defect
Jue Seong Lee, Gi Beom Kim, Won Jung Lee, Seok Hyun Song, Hyo Soon An, Sang Yun Lee, Mi Kyoung Song, Hye Won Kwon, Eun Jung Bae
Korean Circ J. 2021;51(12):1017-1029.    doi: 10.4070/kcj.2021.0076.


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