Surgery for complications of trans-catheter closure of atrial septal defects

Autor: Jeffrey P. Jacobs, George E. Sarris, José Fragata, Stojan Lazarov, Thierry Carrel, Tjark Ebels, Viktor Hraska, Jean Rubay, Giovanni Stellin, Dominique Metras, Christian Schreiber, Prodromos Zavaropoulos, Willem Daenen, Emre Belli, Håkan Berggren, George Kirvassilis, Juan V. Comas, Constantine Mavroudis, Leslie Hamilton, Duccio Di Carlo, Antonio F. Corno
Přispěvatelé: Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
Cardiac Catheterization
medicine.medical_specialty
Adolescent
Septal Occluder Device
medicine.medical_treatment
Heart Septal Defects
Atrial
Atrial septal defects
DISEASE
AMPLATZER DEVICE CLOSURE
Young Adult
Postoperative Complications
medicine
Humans
Minimally Invasive Surgical Procedures
cardiovascular diseases
Trans-catheter device
CARDIAC PERFORATION
Child
Stroke
Device Removal
Aged
Cardiac catheterization
Heart septal defect
business.industry
SURGICAL REVISION
INTERVENTIONAL OCCLUDER PLACEMENT
General Medicine
Middle Aged
medicine.disease
Long-Term Care
Thrombosis
Surgery
Europe
Catheter
Treatment Outcome
Embolism
Child
Preschool
Atrial septal defect
Female
Tamponade
Emergencies
Epidemiologic Methods
Cardiology and Cardiovascular Medicine
business
Complication
Zdroj: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 37(6), 1285-1290. Oxford University Press
Sarris, George E; Kirvassilis, George; Zavaropoulos, Prodromos; Belli, Emre; Berggren, Hakan; Carrel, Thierry; Comas, Juan V; Corno, Antonio F; Daenen, Willem; Di Carlo, Duccio; Ebels, Tjark; Fragata, Jose; Hamilton, Leslie; Hraska, Viktor; Jacobs, Jeffrey; Lazarov, Stojan; Mavroudis, Constantine; Metras, Dominique; Rubay, Jean; Schreiber, Christian; ... (2010). Surgery for complications of trans-catheter closure of atrial septal defects: a multi-institutional study from the European Congenital Heart Surgeons Association. European journal of cardio-thoracic surgery, 37(6), pp. 1285-90. Oxford: Elsevier Science B.V. 10.1016/j.ejcts.2009.12.021
ISSN: 1010-7940
DOI: 10.1016/j.ejcts.2009.12.021
Popis: Objective: This study aims to analyse the collective experience of participating European Congenital Heart Surgeons Association centres in the surgical management of complications resulting from trans-catheter closure of atrial septal defects (ASDs). Methods: The records of all (n = 56) patients, aged 3-70 years (median 18 years), who underwent surgery for complications of trans-catheter ASD closure in 19 participating institutions over a 10-year period (1997-2007) were retrospectively reviewed. Risk factors for surgical complications were sought. Surgical outcomes were compared with those reported for primary surgical ASD closure in the European Association of Cardio-thoracic Surgery Congenital Database. Results: A wide range of ASD sizes (5-34 mm) and devices of various types and sizes (range 12-60 mm) were involved, including 13 devices less than 20 mm. Complications leading to surgery included embolisation (n = 29), thrombosis/thrombo-embolism/cerebral ischaemia or stroke (n = 12), significant residual shunt (n = 12), aortic or atrial perforation or erosion (n = 9), haemopericardium with tamponade (n = 5), aortic or mitral valve injury (n = 2) and endocarditis (n = 1). Surgery (39 early emergent and 17 late operations) involved device removal, repair of damaged structures and ASD closure. Late operations were needed 12 days to 8 years (median 3 years) after device implantation. There were three hospital deaths (mortality 5.4%). During the same time period, mortality for all 4453 surgical ASD closures reported in the European Association of Cardio-Thoracic Surgery Congenital Database was 0.36% ( p = 0.001). Conclusions: Trans-catheter device closure of ASDs, even in cases when small devices are used, can lead to significant complications requiring surgical intervention. Once a complication leading to surgery occurs, mortality is significantly greater than that of primary surgical ASD closure. Major complications can occur late after device placement. Therefore, lifelong follow-up of patients in whom ASDs have been closed by devices is mandatory. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Databáze: OpenAIRE
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