Percutaneous closure of secundum atrial septal defects in pediatric and adult patients: short- and mid-term follow-up results [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2013; 41(8): 705-713 | DOI: 10.5543/tkda.2013.84031

Percutaneous closure of secundum atrial septal defects in pediatric and adult patients: short- and mid-term follow-up results

Yüksel Kaya1, Mustafa Yurtdaş2, Yemlihan Ceylan3, Mustafa Orhan Bulut4, Nihat Söylemez5, Tolga Sinan Güvenç1, Ahmet Karakurt1, Ramazan Akdemir6, Hasan Öztürk7, Yılmaz Güneş6, Bahattin Balcı1, Mehmet Özkan1
1Department Of Cardiology, Kafkas University Medicine Faculty, Kars
2Department Of Cardiology, Lokman Hekim Hospital, Van
3Department Of Cardiology, Yüzüncü Yıl University Medicine Faculty, Van
4Department Of Pediatric Cardiology, Women’s And Child’s Hospital, Van
5Department Of Cardiology, Van Yüksek Ihtisas Education And Research Hospital, Van
6Department Of Cardiology, Sakarya University Medicine Faculty, Sakarya
7Department Of Radiology, Van Yüksek Ihtisas Education And Research Hospital, Van


OBJECTIVES
We aimed to evaluate the short- and mid-term results of patients with atrial septal defect (ASD) who were treated with percutaneous closure.

STUDY DESIGN
Seventy-nine patients with secundum ASD (54 female and 25 male; mean age 26.2±17.2; range 3 to 71] years) were included in this study. Patients were evaluated by transthoracic (TTE) and/or transesophageal echocardiography (TEE). Amplatzer septal occluder (ASO) was used in all patients. In 76 patients, the procedure was performed under local anesthesia with TTE, while in the other 3 patients, it was performed with general anesthesia with TEE. Patients were followed up at the 1st, 3rd, 6th and 12th months and annually thereafter. Mean follow-up time was 13.6±6.6 months.

RESULTS
Mean diameter of ASDs was 18.2±7.5 mm and 20.7±8.04 mm during balloon dilatation, and mean diameter of implanted devices was 22.7±8.5 mm. Procedural time was 40.2±12.6 minutes and fluoroscopy time was 10.9±4.1 minutes. The procedure was successfully performed in all patients (100%). One patient with cardiac tamponade died seven days after cardiac surgery. In two patients, the implanted devices embolized to the pulmonary circulation. Residual flow was found in three patients immediately after the procedure, without residual shunts one month after closure. Mild pericardial effusion in one patient and significant residual shunt due to device malposition in another were discovered during the follow-up at 1 and 6 months, respectively, after the procedure.

CONCLUSION
Our findings showed that percutaneous closure of ASDs is successful in most patients with a low complication rate, and demonstrated that residual shunts do not develop in the majority of patients in the short- and mid-term.

Keywords: Echocardiography, heart catheterization, heart septal defects, atrial/therapy; septal occluder device.

How to cite this article
Yüksel Kaya, Mustafa Yurtdaş, Yemlihan Ceylan, Mustafa Orhan Bulut, Nihat Söylemez, Tolga Sinan Güvenç, Ahmet Karakurt, Ramazan Akdemir, Hasan Öztürk, Yılmaz Güneş, Bahattin Balcı, Mehmet Özkan. Percutaneous closure of secundum atrial septal defects in pediatric and adult patients: short- and mid-term follow-up results. Turk Kardiyol Dern Ars. 2013; 41(8): 705-713

Corresponding Author: Yüksel Kaya, Türkiye
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