Transcatheter Closure of Atrial Septal Defects: Comparable Experience and Outcomes Between Developing and Developed Countries
- 55 Downloads
Atrial septal defect (ASD) is one of the most common congenital heart defects. Transcatheter device closure of ASDs is safe and effective with most of the reported data being described from developed countries. To evaluate the short and mid-term results and experience of device closure of ASDs at a tertiary center in a developing country and compare it to that from developed countries. Retrospective study based on data collection from all patients who have undergone transcatheter percutaneous device closure for ASD from January 2005 until December 2017 at the Children’s Heart Center at the American University of Beirut, Medical Center, Lebanon. During the study period, a total of 254 cardiac catheterizations were performed for device closure of ASDs. The mean age of the patients was 18 ± 17.9 years with 37% being less than 6 years of age. Females were 54%. Defect size ranged from 7 to 37 mm and device size ranged from 8 to 40 mm. The procedure was executed with a success rate of 96%. Five patients had device embolization (2%); in one patient the device was snared and for the remainder the devices were removed surgically. None of the study patients had thrombus formation, neurological complications, bacterial endocarditis, or cardiac erosions. There was no mortality. Device closure of ASDs at our tertiary center in a developing country has an effective and safe profile with excellent results and low complications rates, which compare favorably to those reported from centers in developed countries.
KeywordsAtrial septal defect Transcatheter closure Success rate Complications Developing and developed countries
This research received no specific grant from any funding agency, commercial or not-for-profit sectors.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest related with the manuscript and the study is not supported by any grant or institution.
The study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments. The study was approved by the Institutional Review Board at the American University of Beirut – Medical Center.
- 5.Pac A, Polat TB, Cetin I, Oflaz MB, Balli S (2009) Figulla ASD occluder versus Amplatzer Septal Occluder: a comparative study on validation of a novel device for percutaneous closure of atrial septal defects. J Interv Cardiol 22(6):489–495. https://doi.org/10.1111/j.1540-8183.2009.00497.x CrossRefPubMedGoogle Scholar
- 14.El-Said H, Hegde S, Foerster S, Hellenbrand W, Kreutzer J, Trucco SM, Holzer R, Burch G, Mirani A, Nicolas R, Porras D, Bergersen L, Moore J (2015) Device therapy for atrial septal defects in a multicenter cohort: acute outcomes and adverse events. Catheter Cardiovasc Interv 85(2):227–233. https://doi.org/10.1002/ccd.25684 CrossRefPubMedGoogle Scholar
- 15.Everett AD, Jennings J, Sibinga E, Owada C, Lim DS, Cheatham J, Holzer R, Ringewald J, Bandisode R, Ringel R (2009) Community use of the amplatzer atrial septal defect occluder: results of the multicenter MAGIC atrial septal defect study. Pediatr Cardiol 30(3):240–247. https://doi.org/10.1007/s00246-008-9325-x CrossRefPubMedGoogle Scholar
- 16.Moore JW, Vincent RN, Beekman RH 3rd, Benson L, Bergersen L, Holzer R, Jayaram N, Jenkins K, Li Y, Ringel R, Rome J, Martin GR, NCDR IMPACT Steering Committee (2014) Procedural results and safety of common interventional procedures in congenital heart disease: initial report from the National Cardiovascular Data Registry. J Am Coll Cardiol 64(23):2439–2451. https://doi.org/10.1016/j.jacc.2014.09.045 CrossRefPubMedGoogle Scholar
- 19.Ali SH, El Sisi A, Raafat DM, Amry SE, Mahamoud SED (2018) Short-term outcomes of transcatheter closure of secundum atrial septal defect in children and adolescents: an experience of two centers in Upper Egypt. J Saudi Heart Assoc 30(1):14–20. https://doi.org/10.1016/j.jsha.2017.04.004 CrossRefPubMedGoogle Scholar
- 21.Ali M, Salah El-Din H, Bakhoum S, El-Sisi A, Mahmood K, Farouk H, Kandil H (2018) Feasibility of percutaneous closure of atrial septal defects in adults under transthoracic echocardiography guidance using the Figulla atrial septal defect occluder device. J Saudi Heart Assoc 30(1):21–27. https://doi.org/10.1016/j.jsha.2017.04.002 CrossRefPubMedGoogle Scholar