BACKGROUND: Very few published data is available on the outcomes of balloon assisted techniques (BATs) for trans catheter closure (TCC) of very large (Defined as ≥35 mm size) ostium secundum atrial septal defect (ASD). OBJECTIVE: To study the utility of BAT as against conventional techniques (CT) in TCC of very large ostium secundum ASD (≥35 mm) over the past 5-year period and to find out the association of different morphological features of the defects in relation to TCC outcomes. STUDY DESIGN AND METHODS: Descriptive single center retrospective study of patients with very large ostium secundum ASD (≥35 mm size) who were subjected to TCC. RESULTS: Thirty-three out of 36 patients with ≥35 mm ASD and complex morphological features underwent successful TCC. The study patients had high prevalence of absent aortic and posterior rims with posterior mal-alignment of the septum. BAT was successful in 28/31 (90.3%) patients while CT had a success rate of 16%. The mean trans-esophageal echocardiography (TEE) ASD size with BAT success 37 (SD 1.3) mm and CT failure 36.2 (SD 1.1) mm was not different (P=0.06). On univariate analysis of different morphological features, posterior mal alignment of the septum was associated failure of CT (P=0.01). There was no urgent referral for surgery and patients did well on follow up. CONCLUSIONS: Balloon assisted device closure of (≥35 mm) ASD had 90% success rate. BAT helps in controlled delivery and device alignment in very large ASD with posterior malalignment of the septum and is often helpful when CT fails.
BACKGROUND: Very few published data is available on the outcomes of balloon assisted techniques (BATs) for trans catheter closure (TCC) of very large (Defined as ≥35 mm size) ostium secundum atrial septal defect (ASD). OBJECTIVE: To study the utility of BAT as against conventional techniques (CT) in TCC of very large ostium secundum ASD (≥35 mm) over the past 5-year period and to find out the association of different morphological features of the defects in relation to TCC outcomes. STUDY DESIGN AND METHODS: Descriptive single center retrospective study of patients with very large ostium secundum ASD (≥35 mm size) who were subjected to TCC. RESULTS: Thirty-three out of 36 patients with ≥35 mm ASD and complex morphological features underwent successful TCC. The study patients had high prevalence of absent aortic and posterior rims with posterior mal-alignment of the septum. BAT was successful in 28/31 (90.3%) patients while CT had a success rate of 16%. The mean trans-esophageal echocardiography (TEE) ASD size with BAT success 37 (SD 1.3) mm and CT failure 36.2 (SD 1.1) mm was not different (P=0.06). On univariate analysis of different morphological features, posterior mal alignment of the septum was associated failure of CT (P=0.01). There was no urgent referral for surgery and patients did well on follow up. CONCLUSIONS: Balloon assisted device closure of (≥35 mm) ASD had 90% success rate. BAT helps in controlled delivery and device alignment in very large ASD with posterior malalignment of the septum and is often helpful when CT fails.
Entities:
Keywords:
Very large atrial septal defect (very large ASD); balloon assisted technique (BAT); malaligned septum
Authors: Geoffrey B Crawford; Ralph G Brindis; Mitchell W Krucoff; Benjamin P Mansalis; John D Carroll Journal: Catheter Cardiovasc Interv Date: 2012-05-02 Impact factor: 2.692
Authors: Keila Lopez; Bharat V Dalvi; David Balzer; John L Bass; Tarek Momenah; Qi-Ling Cao; Ziyad M Hijazi Journal: Catheter Cardiovasc Interv Date: 2005-12 Impact factor: 2.692
Authors: P S Rao; E B Sideris; G Hausdorf; C Rey; T R Lloyd; R H Beekman; A M Worms; F Bourlon; E Onorato; M Khalilullah Journal: Am Heart J Date: 1994-11 Impact factor: 4.749
Authors: Chetan Varma; Lee N Benson; Candice Silversides; J Yip; Matthew R Warr; Gary Webb; Samuel C Siu; Peter R McLaughlin Journal: Catheter Cardiovasc Interv Date: 2004-01 Impact factor: 2.692