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Transcatheter closure of large atrial septal defects: feasibility and safety in a large adult and pediatric population.
Baruteau, Alban-Elouen; Petit, Jérôme; Lambert, Virginie; Gouton, Marielle; Piot, Dominique; Brenot, Philippe; Angel, Claude-Yves; Houyel, Lucile; Le Bret, Emmanuel; Roussin, Régine; Ly, Mohamedou; Capderou, André; Belli, Emre.
Afiliação
  • Baruteau AE; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Petit J; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Lambert V; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Gouton M; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Piot D; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Brenot P; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Angel CY; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Houyel L; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Le Bret E; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Roussin R; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Ly M; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Capderou A; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
  • Belli E; From the Marie Lannelongue Hospital-M3C, Department of Pediatric Cardiac Surgery, Paris, France (A.-E.B., J.P., V.L., M.G., D.P., P.B., C.-Y.A., L.H., E.L.B., R.R., M.L., E.B.); Université Paris Sud, Le Kremlin Bicêtre, Paris, France (A.-E.B., A.C.); l'Institut du Thorax, Institut National de la San
Circ Cardiovasc Interv ; 7(6): 837-43, 2014 Dec.
Article em En | MEDLINE | ID: mdl-25423959
ABSTRACT

BACKGROUND:

Data are needed on the safety and efficacy of device closure of large atrial septal defects. METHODS AND

RESULTS:

Between 1998 and 2013, 336 patients (161 children <15 years) with large, isolated, secundum atrial septal defects (balloon-stretched diameter ≥34 mm in adults or echocardiographic diameter >15 mm/m(2) in children) were managed using the Amplatzer device, at the Marie Lannelongue Hospital. Transthoracic echocardiographic guidance was used starting in 2005 (n=219; 65.2%). Balloon-stretched diameter was >40 mm in 36 adults; mean values were 37.6±3.3 mm in other adults and 26.3±6.3 mm/m(2) in children. Amplatzer closure was successful in 311 (92.6%; 95% confidence interval, 89%-95%) patients. Superior and posterior rim deficiencies were more common in failed than in successful procedures (superior, 24.0% versus 4.8%; P=0.002; and posterior, 32.0% versus 4.2%; P<0.001). Device migration occurred in 4 adults (2 cases each of surgical and transcatheter retrieval); in the 21 remaining failures, the device was unreleased and withdrawn. After a median follow-up of 10.0 years (2.5-17 years), all patients were alive with no history of late complications.

CONCLUSIONS:

Closure of large atrial septal defects using the Amplatzer device is safe and effective in both adults and children. Superior and posterior rim deficiencies are associated with procedural failure. Closure can be performed under transthoracic echocardiographic guidance in experienced centers. Early device migration is rare and can be safely managed by device extraction. Long-term follow-up showed no deaths or major late complications in our population of 311 patients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cateterismo Cardíaco / Dispositivo para Oclusão Septal / Comunicação Interatrial Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2014 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cateterismo Cardíaco / Dispositivo para Oclusão Septal / Comunicação Interatrial Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2014 Tipo de documento: Article