Atrial septal defect: Background and indications for ASD closure

2015 ◽  
pp. 462-477
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Asd Closure

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.

Acute Changes in Left Ventricular End Diastolic Pressure following the Transcatheter Closure of an Atrial Septal Defect in Adults

2016 ◽  
Vol 19 (3) ◽  
pp. 145 ◽  
Author(s):  
Young Hwa Kong ◽  
Jinyoung Song ◽  
Kyung Hee Kim ◽  
June Huh ◽  
I-Seok Kang
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Device Closure ◽  
Acute Changes ◽  
Asd Closure

<strong>Background:</strong> Acute changes in left ventricular diastolic function shortly after ASD closure in elderly patients have not been well known. We aimed to investigate acute changes in left ventricular end diastolic pressure (LVEDP) in elderly patients following transcatheter closure of atrial septal defect (ASD). <br /><strong>Methods:</strong> All 19 adults with ASDs who underwent transcatheter closure between June 2013 and December 2014 were enrolled. LVEDP was measured prior to device closure and compared with that immediately following device closure and 15 minutes after device closure. <br /><strong>Results:</strong> The median age of the patients was 48 years old. The baseline E/e’ and LVEDP values were 8.3 ± 2.8 and 13 ± 3 mmHg. The LVEDP value immediately following closure was 19 ± 4 mmHg, and 15 minutes after closure was 16 ± 4 mmHg. The median increase in the LVEDP value immediately following closure was 6 mmHg, which significantly differed from that prior to closure. The LVEDP 15 minutes after closure decreased but remained significantly higher than the value observed immediately after closure. No significant changes were observed with regard to E/e’ at either 1 day or 3 months following closure. The LVEDP value <br />15 minutes after device closure was significantly correlated with those observed before closure and immediately following closure; however, no significant correlations were observed with regard to patient age, Qp/Qs, E/e’ before closure, or E/e’ 3 months after device closure.<br /><strong>Conclusion:</strong> LVEDP in adults with ASDs significantly increases following device closure. LVEDP before closure predicts LVEDP following device closure.

Surgical Strategy in Patients with Atrial Septal Defect and Severe Pulmonary Hypertension

2012 ◽  
Vol 15 (2) ◽  
pp. 111 ◽  
Author(s):  
Yang Hyun Cho ◽  
Tae-Gook Jun ◽  
Ji-Hyuk Yang ◽  
Pyo Won Park ◽  
June Huh ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Maze Procedure ◽  
Severe Pulmonary Hypertension ◽  
Tricuspid Annuloplasty ◽  
Pulmonary Arterial ◽  
Asd Closure

The aim of the study was to review our experience with atrial septal defect (ASD) closure with a fenestrated patch in patients with severe pulmonary hypertension. Between July 2004 and February 2009, 16 patients with isolated ASD underwent closure with a fenestrated patch. All patients had a secundum type ASD and severe pulmonary hypertension. Patients ranged in age from 6 to 57 years (mean � SD, 34.9 � 13.5 years). The follow-up period was 9 to 59 months (mean, 34.5 � 13.1 months). The ranges of preoperative systolic and pulmonary arterial pressures were 63 to 119 mm Hg (mean, 83.8 � 13.9 mm Hg) and 37 to 77 mm Hg (mean, 51.1 � 10.1 mm Hg). The ranges of preoperative values for the ratio of the pulmonary flow to the systemic flow and for pulmonary arterial resistance were 1.1 to 2.7 (mean, 1.95 � 0.5) and 3.9 to 16.7 Wood units (mean, 9.8 � 2.9 Wood units), respectively. There was no early or late mortality. Tricuspid annuloplasty was performed in 14 patients (87.5%). The peak tricuspid regurgitation gradient and the ratio of the systolic pulmonary artery pressure to the systemic arterial pressure were decreased in all patients. The New York Heart Association class and the grade of tricuspid regurgitation were improved in 13 patients (81.2%) and 15 patients (93.7%), respectively. ASD closure in patients with severe pulmonary hypertension can be performed safely if we create fenestration. Tricuspid annuloplasty and a Cox maze procedure may improve the clinical result. Close observation and follow-up will be needed to validate the long-term benefits.

Off-Pump Atrial Septal Defect Closure Using the Universal Cardiac Introducer®

2009 ◽  
Vol 4 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Gerard M. Guiraudon ◽  
Douglas L. Jones ◽  
Daniel Bainbridge ◽  
John T. Moore ◽  
Chris Wedlake ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Image Guidance ◽  
Septal Defect ◽  
Tracking System ◽  
Doppler Imaging ◽  
Atrial Septal Defect Closure ◽  
Off Pump ◽  
Stapling Device ◽  
Future Design ◽  
Asd Closure

Objective Optimal atrial septal defect (ASD) closure should combine off-pump techniques with the effectiveness and versatility of open-heart techniques. We report our experience with off-pump ASD closure using the Universal Cardiac Introducer (UCI) in a porcine model. The goal was to create an ASD over the fossa ovale (FO) and position a patch over the ASD under ultrasound (US) imaging and augmented virtual reality guidance. Methods An US probe (tracked with a magnetic tracking system) was positioned into the esophagus (transesophageal echocardiographic probe) for real-time image-guidance. The right atrium (RA) of six pigs was exposed via a right lateral thoracotomy or medial sternotomy. The UCI was attached to the RA wall. A punching tool was introduced via the UCI, navigated and positioned, under US guidance, to create an ASD into the FO. A patch with its holder and a stapling device were introduced into the RA via the UCI. The patch was positioned on the ASD. Occlusion of the ASD was determined using US and Doppler imaging. Results The FO membrane was excised successfully in all animals. US image-guidance provided excellent visualization. The patch was positioned in all cases with complete occlusion of the ASD. The stapling device proved too bulky, impeding circumferential positioning. Conclusions Using the UCI, ASD closure was safe and feasible. US imaging, combined with virtual and augmented reality provided accurate navigating and positioning. This study also provided valuable information on the future design of anchoring devices for intracardiac procedures.

scholarly journals Cryoballoon Atrial Fibrillation Ablation in a Patient with an Atrial Septal Defect Closure Device

2021 ◽  
Author(s):  
Meisam Mokhtari ◽  
Zahra Khajali ◽  
Mona Heidarali ◽  
Majid Haghjoo
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Septal Defect ◽  
Closure Device ◽  
Atrial Septal Defect Closure ◽  
Occluder Device ◽  
Asd Closure

Atrial fibrillation (AF) is the most commonly treated arrhythmia in clinical practice and is often found in association with an atrial septal defect (ASD). However, ASD closure rarely confers complete arrhythmia control. A 23-year-old man presented to our center with frequent episodes of palpitations. AF was documented in 12-lead electrocardiography, and echocardiography showed a secundum-type ASD, 14 mm in size, with a significant left-to-right shunt. ASD closure was performed successfully with an ASD occluder device with no residual shunting. During follow-up, the patient experienced several episodes of AF. Thirteen months after the ASD closure, cryoballoon pulmonary vein isolation was done successfully with no complications. During a 12-month follow-up, he had no symptoms or AF recurrences, and echocardiography showed no residual shunting. This study showed that cryoballoon pulmonary vein isolation could be performed successfully without residual shunts in patients with ASD closure devices.

Prediction of hemodynamics after atrial septal defect closure using a framework of circulatory equilibrium in dogs

2020 ◽  
Vol 319 (5) ◽  
pp. H938-H947
Author(s):  
Kiyoshi Uike ◽  
Keita Saku ◽  
Takuya Nishikawa ◽  
Kenichiro Yamamura ◽  
Hazumu Nagata ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Safety Management ◽  
Patient Specific ◽  
Defect Closure ◽  
Atrial Septal Defect Closure ◽  
Shunt Flow ◽  
Specific Prediction ◽  
Asd Closure ◽  
The Impact

We developed a framework to predict the impact of atrial septal defect (ASD) closure on hemodynamics by incorporating ASD shunt flow into the framework of circulatory equilibrium. The proposed framework accurately predicted hemodynamics after ASD closure. Patient-specific prediction of hemodynamics may be useful for safety management of ASD closure.

scholarly journals Penanganan Perioperatif Pasien Penyakit Jantung Kongenital Dewasa dengan ASD, Suspek Hipertensi Pulmonal, LV Smallish

2017 ◽  
Vol 9 (2) ◽  
pp. 71
Author(s):  
Wisnhu Wardhana ◽  
Cindy Elfira Boom
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart Disease ◽  
Intensive Care ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Patent Foramen Ovale ◽  
Congenital Heart ◽  
Septal Defect ◽  
Foramen Ovale ◽  
Asd Closure

Penyakit jantung kongenital dewasa / grown-up congenital heart disease   (GUCH) yang menempati urutan teratas dengan insidensi 10% dari jantung kongenital asianotik pada dewasa adalah atrial septal defect (ASD). Terapi optimal ASD masih kontroversial. Operasi direkomendasikan pada pasien usia pertengahan dan usia tua dengan pintasan kiri ke kanan yang bermakna. Komorbid yang paling sering didapatkan pada defek kongenital pada usia dewasa muda adalah gangguan hemodinamik, hipertensi pulmonal, aritmia,  penyakit kardiovaskular dan penyakit resprasi. Dilaporkan pasien perempuan usia 29 tahun dengan atrial septal defect(ASD) dengan hipertensi pulmonaldan Left Ventricle (LV) Smallishyang dilakukan operasi penututupan defek atrial atau ASD closure. Persiapan preoperasi mencakup anamnesa, pemeriksaan fisik dan pemeriksaan penunjang.Perubahan patologi utama adalah peningkatan resistensi vaskuler paru dan perubahan sekunder terhadap peningkatan aliran darah dari pintasan kiri ke kanan. Masalah yang dihadapi pada pasien  perioperasi ini adalah ukuran jantung kiri baik atrium maupun ventrikel kiri yang kecil memberikan dampak hemodinamik tidak stabil berupa aritmia dan pulmonal hipertensi saat dilakukan penutupan defek. Pemberianobat topangan jantung (nitroglyserin, milrinone, norepinephrine, adrenaline) dan pembuatan Patent Foramen Ovale (PFO) memberikan hasil hemodinamik yang stabil selama operasi dan  di ruang perawatan Intensive Care Unit (ICU).

scholarly journals Comparison of Cardiopulmonary Exercise Capacity in Patients with Atrial Septal Defect Treated with Minimally Invasive Cardiac Surgery or Transcatheter Closure

2020 ◽  
Vol 25 (8) ◽  
pp. 3879
Author(s):  
Hicaz Zencirkiran Agus ◽  
Serkan Kahraman ◽  
Mehmet Erturk ◽  
Burak Onan ◽  
Ali Kemal Kalkan ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Exercise Capacity ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Minimally Invasive Cardiac Surgery ◽  
Cardiopulmonary Exercise ◽  
Cardiopulmonary Exercise Capacity ◽  
Asd Closure

Aim. The main aim of our study was to compare the results of transcatheter atrial septal defect (ASD) closure versus minimally invasive cardiac surgery (MICS) focusing on cardiopulmonary exercise capacity and echocardiographic findings preoperatively and 1 month after defect closure.Material and methods. 54 patients with ASD and finally 43 patients who were followed up were included in the study. 21 patients were in MICS (robotic or endoscopic approach) and 22 patients were in transcatheter closure arm. All patients investigated in detail by transesophageal echocardiography and underwent cardiopulmonary exercise test (CPET). At the end of first month, CPET and transthorasic echocardiography were reperformed.Results. There was significant improvement of physical capacity after 1 month following the transcatheter closure procedure documented by exercise time and VO 2 max. Tricuspid annular plane systolic excursion (TAPSE) and tricuspid lateral annular systolic velocity (Tri S) were not changed. In surgery group right heart diameters declined significantly; but VO 2 max, TAPSE and Tri S significantly decreased.Conclusion. Cardiopulmonary exercise function is increased in transcatheter closure group 1 month after closure and contrary not in MICS group. This may be caused by long recovery time of the right ventricle after surgery. Device closure of ASD is preferable to surgical closure if the anatomy is suitable. However, MICS for ASD closure is safe, with short recovery period and less scarring.

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