Device closure of diverse layout of multi-hole secundum atrial septal defect: different techniques and long-term follow-up

Autor: Zeeshan Farhaj, Li Hongxin, Guo Wenbin, Wen-Long Zhang, Fei Liang, Hai-Zhou Zhang, Gui-Dao Yuan, Cheng-Wei Zou
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 14, Iss 1, Pp 1-11 (2019)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-019-0952-5
Popis: Abstract Background There are no unanimous reports on different layouts and classifications of multi-hole secundum atrial septal defects (MHASD) and subsequent standardized occlusion techniques. The MHASD can be isolated or cribriform with variable inter-defects distance. In this retrospective study, experience-based classification and two approaches-based occlusion results are presented. Methods We retrospectively collected and analyzed data of 150 MHASD patients from 1320 patients who underwent atrial septal defect occlusion in our institute. The MHASD patients were categorized into 4 types; type A, B, C and D and occluded under exclusive transesophageal echocardiographic guidance. According to different types, 122 patients were occluded using peratrial approach and 28 patients via percutaneous approach. In type A, single device implantation is performed to occlude the large hole and squeeze the small one. For type B single or double-device deployment was performed depending on an inter-defects distance. In type C and D, a patent foramen-ovale (PF) device was selectively positioned to the central defect to occlude the central defect and cover the peripheral ones. In peratrial approach, 8 patients underwent inter-defects septal puncture technique to achieve single-device occlusion. The intracardiac manipulation time, procedural time, double device deployment, redeployment rate, residual shunt, and proportions were analyzed between (and within peratrial technique) two techniques. Results Successful occlusion was achieved in all 150 patients. Single device occlusion was applied in 78/84 type A and 22/37 type B patients (p
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