scholarly journals Clinical Significance of Septal Malalignment for Transcatheter Closure of Atrial Septal Defect

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yoichi Takaya ◽  
Teiji Akagi ◽  
Koji Nakagawa ◽  
Rie Nakayama ◽  
Takashi Miki ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Clinical Significance ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Adult Patients ◽  
Device Embolization ◽  
Septum Primum ◽  
Device Size ◽  
Selection Of ◽  
Septum Secundum

Background. Septal malalignment is related to erosion and device embolization in transcatheter closure of atrial septal defect (ASD), but limited information is available. Objectives. This study aimed to assess clinical significance of septal malalignment and to determine appropriate evaluation of ASD diameter, including the selection of device size. Methods. Four hundred and seventeen patients with ASD who underwent transcatheter closure were enrolled. Septal malalignment was defined as separation between the septum primum and the septum secundum on transesophageal echocardiography. Results. One hundred and eighty-four patients had septal malalignment. The frequency of septal malalignment increased with age reaching around 50% in adult patients. Septal malalignment was related to aortic rim deficiency. The distance of separation between the septum primum and the septum secundum was 5 ± 2 mm (range, 1–11 mm). In patients with septal malalignment, the ASD diameter measured at the septum primum was 19 ± 6 mm, while the ASD diameter measured at the septum secundum was 16 ± 6 mm. There was a difference of 4 ± 2 mm (range, 0–8 mm) between the ASD diameter measured at the septum primum and that measured at the septum secundum. For transcatheter closure, the Amplatzer Septal Occluder device size 2-3 mm larger and the Occlutech Figulla Flex II device size 4–7 mm larger than the ASD diameter measured at the septum primum were frequently used. During the study period, erosion or device embolization did not occur in all of the patients. Conclusions. Septal malalignment is highly prevalent in adult patients with aortic rim deficiency. The measurement of ASD diameter at the septum primum can be valuable for the selection of device size in patients with septal malalignment.

How Does the Shape of Atrial Septal Defect Impact on the Device Size in Transcatheter Closure?

2013 ◽  
Vol 111 (7) ◽  
pp. 21B
Author(s):  
Jin Young Song ◽  
Sang Yoon Lee ◽  
I-Seok Kang ◽  
Sung-A. Chang ◽  
Seung Woo Park
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Device Size

Transcatheter closure of a complex atrial septal defect after occluder device embolization

2017 ◽  
Vol 18 (6) ◽  
pp. 34-37
Author(s):  
Georgina Fuertes-Ferre ◽  
Felipe Hernández Hernández ◽  
Marta López Ramón ◽  
Juan Sánchez Rubio ◽  
Esther Sánchez Insa ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Device Embolization ◽  
Occluder Device

scholarly journals Transcatheter closure of atrial septal defect with Chinese and Thai nitinol wire mesh occluders in adult patients

2020 ◽  
Author(s):  
Filip Tyc ◽  
Alexander Suchodolski ◽  
Mateusz Knop ◽  
Dominika Rojczyk ◽  
Michał Gałeczka ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Adult Patients ◽  
Wire Mesh ◽  
Nitinol Wire

scholarly journals Very large Atrial Septal Defect Device Closure: Feasibility and safety

2021 ◽  
Vol 42 (2) ◽  
Author(s):  
Goutam Datta
Keyword(s):  
Pericardial Effusion ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Volume Overload ◽  
Ventricular Volume ◽  
Percutaneous Closure ◽  
Device Closure ◽  
Device Embolization ◽  
Male Patients ◽  
Device Size

Objectives: There is limited data regarding feasibility and safety of very large ASD devices deployment. Percutaneous closure of very large atrial septal defect (ASD) is a valid alternative to surgical approach.  But complications like erosion, cardiac perforation, atrioventricular block, pericardial effusion, infective endocarditis, or cardiac arrhythmias may occur following ASD device closure.  Methods: Forty four patients with very large ostium secundum ASD were studied in a tertiary medical centre. Adult patients with defect size of 38 mm or more and device size of 40 mm or more were selected for device closure. Patients having suitable anatomy, significant left to right shunt(>1.5:1) ,right ventricular volume overload and without significant pulmonary arterial hypertension were chosen for device closure. Results : There were thirty six  female patients and  eight  male patients in our study. Majority of our patients (twenty four) were in forty to fifty years age group. Device could be deployed successfully in forty two (95.5%).  Twelve patients had device size of 46 mm (27%). Eight patients had 44 mm devices(18%). Forty two millimeter devices were used in sixteen patients (36%). Eight  patients had device size of  40 mm(18%).Device embolization occurred in two patients. There were two cases of pericardial effusion and pericardiocentesis was needed in one patients. Transient complete heart block was seen in one patient. Four patients had suffered from transient and self terminating atrial arrhythmias. There was no mortality or erosion in our study. Conclusion: Percutaneous closure of very large ASD is feasible and associated with low complication rate

Device Size for Transcatheter Closure of Ovoid Interatrial Septal Defect

2013 ◽  
Vol 16 (4) ◽  
pp. 193
Author(s):  
Eun Hyun Cho ◽  
Jinyoung Song ◽  
Eun Young Choi ◽  
Sang Yoon Lee
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Defect Group ◽  
Amplatzer Septal Occluder ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
The Mean ◽  
Computed Tomography Image ◽  
Device Size

<p><b>Background:</b> For successful transcatheter closure of an atrial septal defect with the Amplatzer septal occluder, the shape of the defect should be considered before selecting the device size. The purpose of this study was to evaluate the results of transcatheter closure of an ovoid atrial septal defect.</p><p><b>Methods:</b> Between January 2010 and February 2012, cardiac computer tomography examinations were performed in 78 patients who subsequently underwent transcatheter closure of an atrial septal defect. In this retrospective study, we reviewed these patients' medical records. We defined an ovoid atrial septal defect as a value of 0.75 for the ratio of the shortest diameter of the defect to the longest diameter, as measured in a computed tomography image. Transthoracic echocardiography examinations were made at 1 day and 6 months after the procedure.</p><p><b>Results:</b> Transcatheter closure of an atrial septal defect was successful in 26 patients in the ovoid-defect group and in 52 patients in the round-defect group. There were no serious complications in either group, and the rate of complete closure at 6 months was 92.3% in the ovoid-defect group and 93.1% in the round-defect group (<i>P ></i> .05). The mean (SD) difference between the device size and the defect's longest diameter, and the mean ratio of the device size to the longest diameter were significantly smaller in the ovoid-defect group (1.7 � 2.9 versus 3.8 � 2.5 and 1.1 � 0.1 versus 1.3 � 0.2, respectively).</p><p><b>Conclusions:</b> Transcatheter closure of an atrial septal defect is indicated even for an ovoid atrial septal defect. Ovoid atrial septal defects can be closed successfully with smaller sizes of the Amplatzer septal occluder than for round atrial septal defects.</p>

Sign in / Sign up

Export Citation Format

Share Document