Transcatheter closure of atrial septal defects in adolescents and adults: technique and difficulties

Acta Med Indones. 2013 Jul;45(3):180-6.

Abstract

Aim: to evaluate the results of transcatheter closure of atrial septal defect (ASD) in adolescents and adult.

Methods: a case series of patients undergoing transcatheter closure of ASD in RS Cipto Mangunkusumo, Jakarta during 2002 -2013. Transesophageal echocardiography, hemodynamic study, and angiography were performed before the procedure. Oxygen test was done if PA pressure was more than 2/3 of aortic pressure, followed by an occlusion test if no response observed to determine whether the device could be released.

Results: we enrolled 54 patients, of whom 26% were adolescents and 3% were males. Median body weight was 49 (26-75) kg and ASD size was 21 (9.4-39.6) mm. The procedure was done under general anesthesia in 26% of patients. Oxygen test was applied in 11% patients and occlusion test in 2% of patient. Transcatheter closure of ASD was successful in all patients using common technique (31%), right pulmonary vein-assisted (65%), left pulmonary assisted (2%), and cutting long sheath (2%). There was neither residual ASD nor complications observed. Mean fluoroscopy and procedure time were 29 (SD 18) and 109 (SD 36) minutes, respectively. Median hospital stay was 1 (1-3) day.

Conclusion: transcatheter closure of ASD in adolescents and adults is safe and effective.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography
  • Arterial Pressure
  • Cardiac Catheterization / methods*
  • Child
  • Echocardiography, Transesophageal
  • Female
  • Heart Septal Defects, Atrial / diagnostic imaging
  • Heart Septal Defects, Atrial / physiopathology
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Operative Time
  • Prosthesis Implantation / methods*
  • Pulmonary Artery
  • Septal Occluder Device*
  • Treatment Outcome
  • Young Adult