Arquivos Brasileiros de Cardiologia (Apr 2013)

Fechamento percutâneo versus cirúrgico da comunicação interatrial em crianças e adolescente Percutaneous versus surgical closure of atrial septal defects in children and adolescents

  • Rodrigo Nieckel da Costa,
  • Marcelo Silva Ribeiro,
  • Fabricio Leite Pereira,
  • Simone Rolim Fontes Pedra,
  • Marcelo Biscegli Jatene,
  • Ieda Biscegli Jatene,
  • Carlos R. Ferreiro,
  • Maria Virginia Tavares Santana,
  • Valmir Fernandes Fontes,
  • Carlos Augusto Cardoso Pedra

Journal volume & issue
Vol. 100, no. 4
pp. 347 – 354

Abstract

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FUNDAMENTO: Há uma paucidade de dados comparando o método percutâneo e o cirúrgico para tratamento da comunicação interatrial tipo ostium secundum. OBJETIVOS: Análise de segurança e eficácia comparando ambos os métodos tratamento em um hospital excelência com vínculo o Ministério de Saúde. MÉTODOS: Estudo observacional, prospectivo, não randomizado de duas coortes de crianças e adolescentes BACKGROUND: There is a scarcity of data comparing percutaneous and surgical closure of the secundum atrial septal defect (ASD). OBJECTIVES: Assessment of safety and efficacy of both methods of treatment in a referral center affiliated with the Ministry of Health. METHODS: Observational, prospective, non-randomized study of two cohorts of children and adolescents younger than 14 years, treated by catheterization or surgery. Data was collected prospectively in the percutaneous group (A) and retrospectively in the surgical group (B). RESULTS: A total of 75 patients (pts) were enrolled in group A from April 2009 to October 2011 and 105 pts were treated in group B from January 2006 to January 2011. Age was older and weight was higher in group B and the ASD diameter was similar in both groups. Technical success was achieved in all procedures and there were no deaths. Complications (most minor) occurred in 68% of group B and 4% of A (p < 0.001). Rates of total occlusion or non-significant residual shunts were similar in both groups. Median hospitalization time was 1.2 days in group A and 8.4 days in group B (p < 0.001). CONCLUSION: Both treatment modalities are safe and effective, showing excellent outcomes. However, the percutaneous treatment has lower morbidity and shorter in-hospital stay length. These observations support the concept that percutaneous treatment of atrial septal defects should be regarded as the method of choice to manage selected patients with this condition.

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