Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T04:45:35.608Z Has data issue: false hasContentIssue false
  • English
  • Français

Transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim under echocardiography only: a feasibility and safety analysis

Part of: Interventional Cardiology

Published online by Cambridge University Press:  12 July 2021

Liu Liu Huang Open the ORCID record for Liu Liu Huang [Opens in a new window] ,
Ji Wu ,
Mai Chen ,
Chun Lan Jiang ,
De C. Zeng ,
Chun Xiao Su  and
Bao Shi Zheng
Liu Liu Huang
Affiliation:
Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Ji Wu*
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Mai Chen
Affiliation:
Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Chun Lan Jiang
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
De C. Zeng
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Chun Xiao Su
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Bao Shi Zheng
Affiliation:
Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
*
Author for correspondence: Ji Wu, Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, No 6 ShuangYong Road Nanning, Guangxi530021, China. Tel: 15507882109. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The safe closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim is a controversial issue. Few studies have been conducted on the closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim without fluoroscopy. This study evaluated the feasibility and safety of echocardiography-guided transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim.

Methods:

The data of 136 patients who underwent transcatheter atrial septal defect closure without fluoroscopy from March 2017 to March 2020 were retrospectively analysed. The patients were classified into the deficient (n = 45) and sufficient (n = 91) posterior-inferior or inferior vena cava rim groups. Procedure and the follow-up results were compared between the two groups.

Results:

Atrial septal defect indexed diameter and the device indexed diameter in the deficient rim group were both larger than that in the sufficient rim group (22.12 versus 17.38 mm/m2, p < 0.001; 24.77 versus 21.21 mm/m2, p = 0.003, respectively). There was no significant difference in the success rate of occlusion between two groups (97.78% in the deficient rim group versus 98.90% in the sufficient rim group, p = 1.000). During follow-up, the incidence of severe adverse cardiac events was not statistically significant (p = 0.551).

Conclusions:

Atrial septal defect with deficient posterior-inferior or inferior vena cava rim can safely undergo transcatheter closure under echocardiography alone if precisely evaluated with transesophageal or transthoracic echocardiography and the size of the occluder is appropriate. The mid-term results after closure are similar to that for an atrial septal defect with sufficient rim.

Keywords

Transcatheter closureatrial septal defectwithout fluoroscopy
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 589 - 596
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amin, Z. Transcatheter closure of secundum atrial septal defects. Catheter Cardiovasc Interv 2006; 68: 778–787.CrossRefGoogle ScholarPubMed
Mendirichaga, R, Smairat, RA, Sancassani, R. Late tissue erosion after transcatheter closure of an atrial septal defect. Catheter Cardiovasc Interv 2017; 89: 502–504.CrossRefGoogle ScholarPubMed
Onakatomi, Y, Asou, T, Takeda, Y, Ueda, H, Goda, M, Masuda, M. Aortic erosion occurring in over 5 years after Amplatzer septal Occluder implantation for secundum atrial septal defect: a case report. J Cardiothorac Surg 2019; 14: 159.CrossRefGoogle ScholarPubMed
McElhinney, DB, Quartermain, MD, Kenny, D, Alboliras, E, Amin, Z. Relative risk factors for cardiac erosion following transcatheter closure of atrial septal defects: a case-control study. Circulation 2016; 133: 1738–1746.CrossRefGoogle ScholarPubMed
Tchantchaleishvili, V, Melvin, AL, Ling, FS, Knight, PA. Late erosion of Amplatzer septal occluder device resulting in cardiac tamponade. Interact Cardiovasc Thorac Surg 2014; 19: 1074–1076.CrossRefGoogle ScholarPubMed
O’Byrne, ML, Gillespie, MJ, Kennedy, KF, Dori, Y, Rome, JJ, Glatz, AC. The influence of deficient retro-aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects: an Analysis of the IMPACT Registry((R)). Catheter Cardiovasc Interv 2017; 89: 102–111.CrossRefGoogle Scholar
Podnar, T, Martanovic, P, Gavora, P, Masura, J. Morphological variations of secundum-type atrial septal defects: feasibility for percutaneous closure using Amplatzer septal occluders. Catheter Cardiovasc Interv 2001; 53: 386–391.CrossRefGoogle ScholarPubMed
Thanopoulos, BD, Dardas, P, Ninios, V, Eleftherakis, N, Karanasios, E. Transcatheter closure of large atrial septal defects with deficient aortic or posterior rims using the “Greek maneuver”. A multicenter study. Int J Cardiol 2013; 168: 3643–3646.CrossRefGoogle ScholarPubMed
Li, GS, Li, HD, Yang, J, et al. Feasibility and safety of transthoracic echocardiography-guided transcatheter closure of atrial septal defects with deficient superior-anterior rims. PLoS One 2012; 7: e51117.CrossRefGoogle ScholarPubMed
Chen, Q, Chen, LW, Cao, H, Zhang, GC, Chen, DZ, Zhang, H. Intraoperative device closure of atrial septal defects with inferior vena cava rim deficiency: a safe alternative to surgical repair. J Thorac Cardiovasc Surg 2011; 141: 631–636.CrossRefGoogle ScholarPubMed
Kijima, Y, Akagi, T, Takaya, Y, et al. Deficient surrounding rims in patients undergoing transcatheter atrial septal defect closure. J Am Soc Echocardiogr 2016; 29: 768–776.CrossRefGoogle ScholarPubMed
Mathewson, JW, Bichell, D, Rothman, A, Ing, FF. Absent posteroinferior and anterosuperior atrial septal defect rims: factors affecting nonsurgical closure of large secundum defects using the Amplatzer occluder. J Am Soc Echocardiogr 2004; 17: 62–69.CrossRefGoogle ScholarPubMed
Amedro, P, Bayburt, S, Assaidi, A, et al. Should transcatheter closure of atrial septal defects with inferior-posterior deficient rim still be attempted? J Thorac Dis 2019; 11: 708–716.CrossRefGoogle ScholarPubMed
Schubert, S, Kainz, S, Peters, B, Berger, F, Ewert, P. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol 2012; 101: 691–700.CrossRefGoogle ScholarPubMed
Yang, Y, Zhang, W, Wu, Q, Gao, L, Jin, W, Zhao, T. Transcatheter closure of atrial septal defects without fluoroscopy: a well-established procedure for alternative use in children. EuroIntervention 2016; 12: e652–e657.CrossRefGoogle ScholarPubMed
Ackermann, S, Quandt, D, Hagenbuch, N, et al. Transcatheter atrial septal defect closure in children with and without fluoroscopy: a comparison. J Interv Cardiol 2019; 2019: 1–9.CrossRefGoogle ScholarPubMed
Papa, M, Gaspardone, A, Fragasso, G, et al. Feasibility and safety of transcatheter closure of atrial septal defects with deficient posterior rim. Catheter Cardiovasc Interv 2013; 81: 1180–1187.CrossRefGoogle ScholarPubMed
Boutin, C, Musewe, NN, Smallhorn, JF, Dyck, JD, Kobayashi, T, Benson, LN. Echocardiographic follow-up of atrial septal defect after catheter closure by double-umbrella device. Circulation 1993; 88: 621–627.CrossRefGoogle ScholarPubMed
Jalal, Z, Hascoet, S, Gronier, C, et al. Long-term outcomes after percutaneous closure of ostium secundum atrial septal defect in the young: a nationwide cohort study. JACC Cardiovasc Interv 2018; 11: 795–804.CrossRefGoogle Scholar
Baruteau, AE, Hascoet, S, Fraisse, A. Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children. J Thorac Dis 2017; 9: 1247–1256.CrossRefGoogle ScholarPubMed
Haas, NA, Soetemann, DB, Ates, I, 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; 88: 571–581.CrossRefGoogle ScholarPubMed
Rigatelli, G, Nghia, NT, Zuin, M, Conte, L, D’Elia, K, Nanjundappa, A. Very long-term outcomes of transcatheter secundum atrial septal defect closure using intracardiac echocardiography without balloon sizing. Clin Radiol 2019; 74: 732 e717–732 e722.CrossRefGoogle ScholarPubMed
Baykan, ALI, Pamukcu, O, Ozyurt, A, et al. Is it safe to close asd with the guidance of transthoraxic echocardiography in pediatric population “Ten Years’ experience of a single center”. J Interv Cardiol 2015; 28: 172–179.CrossRefGoogle Scholar
Ewert, P. Morphology of perforated atrial septal aneurysm suitable for closure by transcatheter device placement. Heart 2000; 84: 327–331.CrossRefGoogle ScholarPubMed
Bartakian, S, El-Said, HG, Printz, B, Moore, JW. Prospective randomized trial of transthoracic echocardiography versus transesophageal echocardiography for assessment and guidance of transcatheter closure of atrial septal defects in children using the Amplatzer septal occluder. JACC Cardiovasc Interv 2013; 6: 974–980.CrossRefGoogle ScholarPubMed
Varma, C, Benson, LN, Silversides, C, et al. Outcomes and alternative techniques for device closure of the large secundum atrial septal defect. Catheter Cardiovasc Interv 2004; 61: 131–139.CrossRefGoogle ScholarPubMed
Butera, G, Romagnoli, E, Carminati, M, et al. Treatment of isolated secundum atrial septal defects: impact of age and defect morphology in 1,013 consecutive patients. Am Heart J 2008; 156: 706–712.CrossRefGoogle ScholarPubMed
Yan, C, Wang, C, Pan, X, et al. Three-dimensional printing assisted transcatheter closure of atrial septal defect with deficient posterior-inferior rim. Catheter Cardiovasc Interv 2018; 92: 1309–1314.CrossRefGoogle ScholarPubMed
Yan, C, Li, S, Song, H, et al. Off-label use of duct occluder in transcatheter closure of secundum atrial septal defect with no rim to right pulmonary vein. J Thorac Cardiovasc Surg 2019; 157: 1603–1608.CrossRefGoogle ScholarPubMed
Leon, MB, Smith, CR,Mack, M,et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010; 363: 1597–1607.CrossRefGoogle ScholarPubMed
Adams, DH, Popma, JJ, Reardon, MJ, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med 2014; 370: 1790–1798.CrossRefGoogle ScholarPubMed
Remadevi, KS,Francis, E,Kumar, RK. Catheter closure of atrial septal defects with deficient inferior vena cava rim under transesophageal echo guidance. Catheter Cardiovasc Interv 2009; 73: 90–96.CrossRefGoogle ScholarPubMed
Lipiec, P, Filipiak-Strzecka, D, Szymczyk, K, Peruga, JZ, Kasprzak, JD. Intramural atrial haematoma as a complication of the percutaneous atrial septal defect closure. Eur Heart J Cardiovasc Imaging 2017; 18: 1185.Google ScholarPubMed
Park, J-J, Lee, SC, Kim, JB, et al. Deterioration of mitral valve competence after the repair of atrial septal defect in adults. Ann Thorac Surg 2011; 92: 1629–1633.CrossRefGoogle ScholarPubMed
Takaya, Y, Akagi, T, Kijima, Y, Nakagawa, K, Sano, S, Ito, H. Long-term outcome after transcatheter closure of atrial septal defect in older patients: impact of age at procedure. JACC Cardiovasc Interv 2015; 8: 600–606.CrossRefGoogle ScholarPubMed
Yoshida, S, Numata, S, Tsutsumi, Y, et al. Mitral valve regurgitation after atrial septal defect repair in adults. J Heart Valve Dis 2014; 23: 310–315.Google ScholarPubMed