Document Type : Original Article

Authors

1 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/arya.2024.31245

Abstract

BACKGROUND: Secundum Atrial Septal Defects (ASDs) are the most common type of atrial septal defects. Today, using different types of occluders, transcatheter closure is widely used to treat ASD and has replaced the surgical procedure in anatomically suitable patients. This study was performed to evaluate the short-term clinical outcomes of treatment of adult patients requiring an ASD device closure referred to Shahid Chamran Cardiovascular Center in Isfahan, Iran.
METHODS: All patients who underwent ASD treatment using transcatheter closure at Shahid Chamran Cardiovascular Center in 2020 and 2021 were recruited in this retrospective descriptive study. The characteristics of the treated lesion and the cardiovascular complications during treatment were recorded immediately and one month after treatment.
RESULTS: A total of 70 patients (47 females and 23 males) with a mean age of 39.81±12.56 years were investigated in this study. The number of difficult anomalies was 46 (65.7%), and the most common type was the deficient aortic rim. In terms of the incidence of vascular complications, hematoma, bleeding, and pseudoaneurysm were observed in 8 patients. The most common cardiac complication was atrial fibrillation, which occurred in 12 patients. No cardiovascular complications were observed during the one-month follow-up.
CONCLUSION: The results of this single-institute study showed that ASD treatment by the transcatheter procedure using an ASO device at Shahid Chamran Cardiovascular Center was performed safely and successfully with very few complications. The short-term analysis of the outcomes indicated no major complications, deaths, or device malposition.

Keywords

1. Askari B, Soraya H, Ayremlu N, Golmohammadi M. Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran. Egypt Heart J. 2018 Dec;70(4):249-53. https://doi.org/10.1016/j.ehj.2018.09.003
2. Qiu HF, Chen Q, Hong ZN, Chen LW, Huang XS. Transcatheter and intraoperative device closure and surgical repair for atrial septal defect. J Cardiothorac Surg. 2019 Jul 19;14(1):136. https://doi.org/10.1186/s13019-019-0957-0
3. Kim NK, Park SJ, Choi JY. Transcatheter closure of atrial septal defect: does age matter? Korean Circ J. 2011 Nov;41(11):633-8. https://doi.org/10.4070%2Fkcj.2011.41.11.633
4. Abdi S, Kiani R, Momtahen M, Basiri HA, Maadani M, Abdolrahimi S, et al. Percutaneous device closure for secundum-type atrial septal defect: short and intermediate-term results. Arch Iran Med. 2012 Nov;15(11):693-5.
5. Cowley CG, Lloyd TR, Bove EL, Gaffney D, Dietrich M, Rocchini AP. Comparison of results of closure of secundum atrial septal defect by surgery versus Amplatzer septal occluder. Am J Cardiol. 2001 Sep 1;88(5):589-91. https://doi.org/10.1016/s0002-9149(01)01750-7
6. Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K; Amplatzer Investigators. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol. 2002 Jun 5;39(11):1836-44. https://doi.org/10.1016/s0735-1097(02)01862-4
7. Formigari R, Di Donato RM, Mazzera E, Carotti A, Rinelli G, Parisi F, et al. Minimally invasive or interventional repair of atrial septal defects in children: experience in 171 cases and comparison with conventional strategies. J Am Coll Cardiol. 2001 May;37(6):1707-12. https://doi.org/10.1016/s0735-1097(01)01213-x
8. Ooi YK, Kelleman M, Ehrlich A, Glanville M, Porter A, Kim D, et al. Transcatheter Versus Surgical Closure of Atrial Septal Defects in Children: A Value Comparison. JACC Cardiovasc Interv. 2016 Jan 11;9(1):79-86. https://doi.org/10.1016/j.jcin.2015.09.028
9. Moore J, Hegde S, El-Said H, Beekman R, 3rd, Benson L, Bergersen L, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv. 2013 May;6(5):433-42. https://doi.org/10.1016/j.jcin.2013.02.005
10. Nasiri Brojeni M, Seilan P, Parsaee M, Saedi S. Postoperative Outcome of the Transcatheter Closure of Atrial Septal Defects Using the AMPLATZER Septal Occluder. Iran Heart J. 2016;17(4):30-5.
11. Kim AY, Jung SY, Chang JY, Jung JW, Choi JY. Early to Mid-Term Follow-Up Outcomes of Percutaneous Closure of Atrial Septal Defects Using Recent Generation Devices: a Single-Center Experience. Korean Circ J. 2019 Apr;49(4):326-35. https://doi.org/10.4070/kcj.2018.0278
12. Wang JK, Tsai SK, Wu MH, Lin MT, Lue HC. Short- and intermediate-term results of transcatheter closure of atrial septal defect with the Amplatzer Septal Occluder. Am Heart J. 2004 Sep;148(3):511-7. https://doi.org/10.1016/j.ahj.2004.01.030
13. Snijder RJR, Renes LE, Bosshardt D, Suttorp MJ, Ten Berg JM, Post MC. Percutaneous Atrial Septal Defect Closure Using the Occlutech Figulla Device in Adults: More than 800 Patient-Years of Follow-Up. J Interv Cardiol. 2020 Feb 14;2020:7136802. https://doi.org/10.1155/2020/7136802
14. Haas NA, Soetemann DB, Ates I, Baspinar O, Ditkivskyy I, Duke C, et al. Closure of Secundum Atrial Septal Defects by Using the Occlutech Occluder Devices in More Than 1300 Patients: The IRFACODE Project: A Retrospective Case Series. Catheter Cardiovasc Interv. 2016 Oct;88(4):571-81. https://doi.org/10.1002/ccd.26497
15. Butera G, Carminati M, Chessa M, Youssef R, Drago M, Giamberti A, et al. Percutaneous versus surgical closure of secundum atrial septal defect: comparison of early results and complications. Am Heart J. 2006 Jan;151(1):228-34. https://doi.org/10.1016/j.ahj.2005.02.051
16. Dugal JS, Jetley V, Singh C, Datta SK, Sabharwal JS, Sofat S. Amplatzer Device closure of Atrial Septal Defects and Patent Ductus Arteriosus: Initial Experience. Med J Armed Forces India. 2003 Jul;59(3):218-22. https://doi.org/10.1016/s0377-1237(03)80011-4
17. Amin Z. Transcatheter closure of secundum atrial septal defects. Catheter Cardiovasc Interv. 2006 Nov;68(5):778-87. https://doi.org/10.1002/ccd.20872
18. Zhang CJ, Huang YG, Huang XS, Huang T, Huang WH, Shen JJ. Transcatheter closure of patent foramen ovale in Chinese patients with paradoxical embolism. -Immediate results and long-term follow-up-. Circ J. 2011;75(8):1867-71. https://doi.org/10.1253/circj.cj-11-0068
19. Ostovan MA, Kojuri J, Dehghani P, Razazi V, Moarref A. Device closure in adults with atrial septal defect in Shiraz, a single center registry. J Cardiovasc Thorac Res. 2016;8(1):40-2. https://doi.org/10.15171/jcvtr.2016.07
20. Behjati M, Rafiei M, Soltani MH, Emami M, Dehghani M. Transcatheter closure of atrial septal defect with amplatzer septal occluder in adults: immediate, short, and intermediate-term results. J Tehran Heart Cent. 2011 Spring;6(2):79-84.
21. Majunke N, Bialkowski J, Wilson N, Szkutnik M, Kusa J, Baranowski A, et al. Closure of atrial septal defect with the Amplatzer septal occluder in adults. Am J Cardiol. 2009 Feb 15;103(4):550-4. https://doi.org/10.1016/j.amjcard.2008.10.018
22. Johnson JN, Marquardt ML, Ackerman MJ, Asirvatham SJ, Reeder GS, Cabalka AK, et al. Electrocardiographic changes and arrhythmias following percutaneous atrial septal defect and patent foramen ovale device closure. Catheter Cardiovasc Interv. 2011;78(2):254-61. https://doi.org/10.1002/ccd.23028
23. Kong X, Cao K, Yang R, Xu D, Sheng Y, Huang J, Ma W. Transcatheter closure of secundum atrial septal defect using an Amplatzer septal occluder. Chin Med J (Engl). 2002 Jan;115(1):126-8.