Van Tıp Dergisi (Sep 2020)

Efficacy and Safety of Percutaneous Closure of Secundum Type Atrial Septal Defects: A Single Center Experience

  • Fatih Öztürk,
  • Haşim Tüner,
  • Naci Babat

DOI
https://doi.org/10.5505/vtd.2020.87523
Journal volume & issue
Vol. 27, no. 4
pp. 427 – 430

Abstract

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INTRODUCTION: Atrial septal defect (ASD) is one of the most common congenital heart diseases. Secundum ASD consists 80% of all septal defects. Atrial arrhythmias, paradoxical embolism, right ventricular failure, and irreversible pulmonary hypertension might be complications of untreated ASD. Percutaneous closure of ASDs is accepted as superior than surgical approach because of its lesser complication rate, lower cost, and higher success rate in long term. METHODS: The study conducted as retrospectively. Total of 75 patients were enrolled to the current trial who were admitted to the cardiology outpatient department of Van Yuzuncu Yil University and diagnosed with secundum ASD by both transthoracic and transesophageal echocardiographic examinations. Patients whose aortic rim was shorter than 5 mm and atrial septal defect diameter longer than 38 mm were excluded. Qp/Qs ratio was bigger than >1.5 in all of our patients. RESULTS: The data of 75 patients were included and the ASD was occluded successfully in 69 of 75. There was 41 women and 34 men in our study group. The average age of patients was 36 +- (18-59) years. Qp/Qs> 1,5 in 92% of all patients and other indications in the closure of ASD were the presence of thromboembolism history, impaired exercise tolerance, atrial arrhythmias, the evidence of pulmonary hypertension, and volume overload in right ventricle. The mean Qp/Qs ratio detected by echocardiographically was 1.9+-08(1.29-2.6) in our patients. DISCUSSION AND CONCLUSION: The closure of ASD by ASO is superior to surgery approach because of lower cost and shorter duration of hospital stay. It is accepted as first approach in the treatment of ASD due to its higher success and lesser complication rate. However, knowledgeable operator and experienced team members are extremely crucial in the percutaneous closure of ASD and it must be considered in the decision of approach strategy.

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