Transcatheter closure of adults with atrial septal defect and atrial fibrillation-The right thing to do

2009 ◽  
Vol 73 (5) ◽  
pp. 687-687 ◽  
Author(s):  
Douglas S. Moodie
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
The Right

scholarly journals Velocity Vector Imaging Assessment of Functional Change in the Right Ventricle during Transcatheter Closure of Atrial Septal Defect by Intracardiac Echocardiography

2020 ◽  
Vol 9 (4) ◽  
pp. 1132
Author(s):  
Se Yong Jung ◽  
Jae Il Shin ◽  
Jae Young Choi ◽  
Su-Jin Park ◽  
Nam Kyun Kim
Keyword(s):  
Right Ventricle ◽  
Atrial Septal Defect ◽  
Velocity Vector ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Intracardiac Echocardiography ◽  
Functional Change ◽  
Longitudinal Displacement ◽  
Before And After ◽  
The Right

The functional change of the right ventricle (RV) after atrial septal defect (ASD) via transcatheter closure is well known. We assessed the immediate RV functional change using velocity vector imaging (VVI) with intracardiac echocardiography (ICE). Seventy-four patients who underwent transcatheter closure of an ASD were enrolled. VVI in the “home view” of ICE showing the RV was obtained before and after the procedure. Velocity, strain, strain rate (SR), and longitudinal displacement were analyzed from VVI data, and the changes of these parameters before and after the procedure were compared. The velocity of the RV decreased after ASD transcatheter closure (3.97 ± 1.48 to 3.56 ± 1.4, p = 0.024), especially in the RV inlet and outlet. The average strain decreased (−19.21 ± 5.79 to −16.87 ± 5.03, p = 0.002), as did the average SR (−2.28 ± 0.64 to −2.03 ± 0.61, p = 0.006). The average longitudinal displacement did not differ. With the VVI technique, we could clearly observe RV functional change immediately after transcatheter closure of the ASD. RV functional change with regional difference may reflect the heterogeneity of volume reduction and suggest subclinical RV dysfunction. These findings can enhance our understanding of the physiologic changes in the RV during reverse remodeling.

scholarly journals Cobrahead Deformity in the Right Atrial Disc of a New-Generation Occlutech Figulla Flex II Atrial Septal Defect Occluder Device

2015 ◽  
Vol 42 (5) ◽  
pp. 454-457 ◽  
Author(s):  
Teoman Kilic ◽  
Ertan Ural ◽  
Tayfun Sahin
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Right Atrial ◽  
Amplatzer Septal Occluder ◽  
Atrial Septal Defect Closure ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
The Right ◽  
New Generation

Cobrahead deformity is a known (but uncommon) phenomenon associated with the left atrial disc of the Amplatzer or Occlutech Figulla septal occluder device during percutaneous transcatheter atrial septal defect closure. It has also been postulated that the right atrial disc of the Amplatzer septal occluder device might upon occasion exhibit the cobrahead malformation. To date, only one case report concerning the cobrahead deformity in the right atrial disc of an Amplatzer septal occluder has been published, if we discount a report published as a letter to the manufacturer. Here we present the first report (known to us) of a cobrahead deformity in the right atrial disc of an Occlutech Figulla Flex II atrial septal defect occluder device during transcatheter closure of a complex atrial septal defect.

Secundum atrial septal defects transcatheter closure versus surgery in adulthood: a 2000–2020 systematic review and meta-analysis of intrahospital outcomes

2021 ◽  
pp. 1-6
Author(s):  
Gianluca Rigatelli ◽  
Marco Zuin ◽  
Loris Roncon ◽  
Aravinda Nanjiundappa
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Hospital Mortality ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Perioperative Stroke ◽  
Transcatheter Device

Abstract Introduction: Technologically, advances in both transcatheter and surgical techniques have been continuing in the past 20 years, but an updated comprehensive comparison in device-based versus surgery in adults in terms of incidence of in-hospital mortality, perioperative stroke, and atrial fibrillation onset is still lacking. We investigate the performance of transcatheter device-based closure compared to surgical techniques by a systematic review and meta-analysis of the last 20 years literature data. Material and methods: The analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Literature search was performed based on Cochrane Library, Embase, PubMed, and Google Scholar to locate articles published between January 2000 and October 2020, regarding the comparison between short-term outcome and post-procedural complications of atrial septal defect patients receiving transcatheter or surgical closure. The primary outcome was the comparison of in-hospital mortality from all causes between patients treated with transcatheter closure or cardiac. Secondary outcomes were the onset of post-procedural atrial fibrillation or perioperative stroke. Results: A total of 2360 patients were included of which 1393 [mean age 47.6 years, 952 females (68.3%)] and 967 [mean age 40.3 years, 693 females (71.6%)] received a transcatheter device-based and surgery closure, respectively. In-hospital mortality [OR 0.16 (95% CI (0.66−0.44)), p = 0.0003, I2 = 0%], perioperative stroke [OR 0.51 (95% CI (0.31−0.84)), p = 0.003, I2 = 79%], and post-procedural atrial fibrillation [OR 0.14 (95% CI (0.03−0.61)), p = 0.009, I2 = 0%] significantly favoured transcatheter device-based closure Conclusion: Transcatheter atrial septal defect closure resulted safer in terms of in-hospital mortality, perioperative stroke, and post-procedural atrial fibrillation compared to traditional surgery.

Atrial fibrillation following transcatheter atrial septal defect closure: a systematic review and meta-analysis

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319794
Author(s):  
Jonah Daniel Himelfarb ◽  
Healey Shulman ◽  
Christopher James Olesovsky ◽  
Rawan K Rumman ◽  
Laura Oliva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
De Novo ◽  
Transcatheter Closure ◽  
Meta Analysis ◽  
Congenital Cardiac Anomalies ◽  
New Onset

ObjectiveThe ostium secundum atrial septal defect (ASD) is among the most common congenital cardiac anomalies diagnosed in adulthood. A known complication of transcatheter ASD closure is the development of new-onset atrial fibrillation and flutter (AFi/AFl). These arrhythmias confer an increased risk of postoperative stroke, thrombus formation and systemic emboli. This systematic review examines the burden of de novo AFi/AFl in adults following transcatheter closure and seeks to identify risk factors for AFi/AFl development.MethodsStudies were identified by a search of MEDLINE, EMBASE and Cochrane databases from inception until 29 April 2020. A meta-analysis of AFi/AFl incidence was performed using a random-effects model.ResultsA total of 31 studies met inclusion criteria, comprising 4788 adult patients without a history of AFi/AFl. Twenty-three studies were included in quantitative synthesis and demonstrated an overall incidence rate of 1.82 patients per 100 person-years of follow-up (I2=83%). In studies that enrolled only patients ≥60 years old, the incidence was 5.21 patients per 100 person-years (I2=0%). Studies with follow-up duration ≤2 years reported an incidence of 4.05 per 100 person-years (I2=55%) compared with a rate of 1.19 per 100 person-years (I2=85%) for studies with follow-up duration >2 years.ConclusionsThe incidence of new-onset AFi/AFl is relatively low following transcatheter closure of secundum ASDs. The rate of de novo AFi/AFl, however, was significantly higher in elderly patients. Shorter follow-up time was associated with a higher reported incidence of AFi/AFl.

scholarly journals P1246 The Eustachian valve: a structure not so innocent

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T E Graca Rodrigues ◽  
R Placido ◽  
C David ◽  
S Goncalves ◽  
F J Pinto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Vena Cava ◽  
Eustachian Valve ◽  
The Right

Abstract Background The eustachian valve is an embryological remnant of the inferior vena cava (IVC) valve. It is usually absent or inconspicuous and has no known function in the normal adult. However, there are reports suggesting that the EV is not as innocent as we thought. The EV can be a site of infective vegetations or be mistaken for a thrombus or tumor. The EV can also make interventional procedures (closure of ASD (atrial septal defect) or ablation for atrial flutter) more laborious. Clinical Case A 80 year-old female patient was referred to the emergency department after an episode of acute palpitations, right chest pain, followed by syncope. She had a previous medical history of type 2 diabetes and epilepsy. On admission she was normotensive (104/67mmHg). The ECG showed atrial fibrillation with heart rate of 180 beats per minute. The echocardiogram show slight dilation of the right ventricle and bilateral atrial dilatation. The blood tests documented an elevated D-dimers 2,73 μg/mL, troponin (hs-TNT 27ng/L) and NT-proBNP 4339pg/ml, with a normal renal function. Computed tomographic (CT) pulmonary angiography revealed filling defects on the segmentar and subsegmentar inferior lobes, compatible with the diagnosis of pulmonary embolism and also revealed a dilatation of the main pulmonary trunk (35mm). Based on this result the patient start anticoagulation with low molecular weight heparin and heart rate control with bisoprolol. However besides of this strategy the patient remain in atrial fibrillation without a controlled hear rate and an transesophageal echocardiography (TOE) was performed. The TOE shown a small freely mobile mass – thombi - at the inferior vena cava-right atrium (IVC-RA) junction tethered at the eustachian valve; a small atrial septal defect (4mm) – ostium secundum type – with a left to right shunt; and a preserved biventricular function (figure 1). Based on this exams we optimize the therapy with digoxin and amiodarone with a good control of the heart rate and patient was discharge on warfarine, bisoprolol and digoxin asymptomatic and to be reevaluated on cardiology clinic. Discussion/Conclusion: The eustachian valve in adult is an embryological remainder of the fetal venous sinus valve. This structure is located in the right atrium and is a common, not pathological, echocardiographic finding. It is known that a small percentage of the pulmonary embolisms, thrombi are discovered in the right side of the heart; however, their presence on the Eustachian valve is very unusual. Besides this in our particular case in the present we will have also to ensure that the anticoagulation is effective to avoid that the trombi migrates into the systemic circulation by the atrial septal defect. Abstract P1246 Figure.

Surgical Intervention for Embolization of Atrial Septal Defect Closure Devices: Case Report

2013 ◽  
Vol 16 (5) ◽  
pp. E274-E275
Author(s):  
Hakan Vural ◽  
Tahsin Bozat ◽  
Derih Ay ◽  
M. Çağdaş Çayir ◽  
Arif Gücü ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Transcatheter Closure ◽  
Atrial Septal Defect Closure ◽  
Amplatzer Device ◽  
Device Embolization ◽  
Asd Closure ◽  
The Right ◽  
Transcatheter Device

Atrial septal defect (ASD) closure using a percutaneous transcatheter device is used as an alternative to surgery. Various devices are increasingly used in clinical practice, and various types and models of septal occluder devices are available. The Amplatzer device (Amplatzer Medical, Golden Valley, MN, USA) is one with increasing popularity.We report a case of attempted percutaneous transcatheter closure of a large ASD in a 14-year-old girl, complicated by total device embolization to the right ventricle necessitating emergency surgery.

Transcatheter closure of atrial septal defect in elderly patients with permanent atrial fibrillation

2009 ◽  
Vol 73 (5) ◽  
pp. 682-686 ◽  
Author(s):  
Manabu Taniguchi ◽  
Teiji Akagi ◽  
Shinichi Ohtsuki ◽  
Yoshio Okamoto ◽  
Yasuharu Tanabe ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Permanent Atrial Fibrillation

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

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