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Intraoperative device closure of atrial septal defects in the Older Population
OBJECTIVE: This study sought to prove the safety and feasibility of intraoperative device closure of atrial septal defect (ASD) with transthoracic minimal invasion in the older patients. METHODS: From January 2006 to December 2009, 47 patients aged 50 years or more and suffered from atrial septal de...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195093/ https://www.ncbi.nlm.nih.gov/pubmed/21958758 http://dx.doi.org/10.1186/1749-8090-6-123 |
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author | Zhang, Hui Chen, Qiang Chen, Liang-Wan Cao, Hua Zhang, Gui-Can Chen, Dao-Zhong |
author_facet | Zhang, Hui Chen, Qiang Chen, Liang-Wan Cao, Hua Zhang, Gui-Can Chen, Dao-Zhong |
author_sort | Zhang, Hui |
collection | PubMed |
description | OBJECTIVE: This study sought to prove the safety and feasibility of intraoperative device closure of atrial septal defect (ASD) with transthoracic minimal invasion in the older patients. METHODS: From January 2006 to December 2009, 47 patients aged 50 years or more and suffered from atrial septal defect were enrolled in our institution. Patients were divided into two groups, 27 of which in group I with intraoperative device closure and the other 20 in group II with surgical closure. In group I, the method involved a minimal intercostal incision, which was performed after full evaluation of the atrial septal defect by transthoracic echocardiography, and the insertion of the device through the delivery sheath to occlude the atrial septal defect. RESULTS: In group I, implantation was ultimately successful in all patients. The complete closure rate at 24 hours and 1 year were 81.5% and 100% respectively. In 6 of 27 patients, minor complications occurred: transient arrhythmia (n = 5) and blood transfusion (n = 3). In group II, all patients were closured successfully; almost all of them needed blood transfusion and suffered from various minor complications though. During a follow-up period of 1 to 5 years, no residual shunt, noticeable mitral regurgitation, significant arrhythmias, thrombosis, or device failure were found. In our comparative studies, group II had significantly longer ICU stay and hospital stay than group I (p < 0.05). The cost of group I was less than that of group II(p < 0.05). CONCLUSIONS: Minimally invasive transthoracic device closure of the atrial septal defect at advanced age with a domestically made device without cardiopulmonary bypass is safe and feasible under transthoracic echocardiographic guidance. It was cost-savings, yielding better cosmetic results and leaving fewer traumas than surgical closure. Early and mid-term results are encouraging. However, it is necessary to evaluate the long-term results. |
format | Online Article Text |
id | pubmed-3195093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31950932011-10-18 Intraoperative device closure of atrial septal defects in the Older Population Zhang, Hui Chen, Qiang Chen, Liang-Wan Cao, Hua Zhang, Gui-Can Chen, Dao-Zhong J Cardiothorac Surg Research Article OBJECTIVE: This study sought to prove the safety and feasibility of intraoperative device closure of atrial septal defect (ASD) with transthoracic minimal invasion in the older patients. METHODS: From January 2006 to December 2009, 47 patients aged 50 years or more and suffered from atrial septal defect were enrolled in our institution. Patients were divided into two groups, 27 of which in group I with intraoperative device closure and the other 20 in group II with surgical closure. In group I, the method involved a minimal intercostal incision, which was performed after full evaluation of the atrial septal defect by transthoracic echocardiography, and the insertion of the device through the delivery sheath to occlude the atrial septal defect. RESULTS: In group I, implantation was ultimately successful in all patients. The complete closure rate at 24 hours and 1 year were 81.5% and 100% respectively. In 6 of 27 patients, minor complications occurred: transient arrhythmia (n = 5) and blood transfusion (n = 3). In group II, all patients were closured successfully; almost all of them needed blood transfusion and suffered from various minor complications though. During a follow-up period of 1 to 5 years, no residual shunt, noticeable mitral regurgitation, significant arrhythmias, thrombosis, or device failure were found. In our comparative studies, group II had significantly longer ICU stay and hospital stay than group I (p < 0.05). The cost of group I was less than that of group II(p < 0.05). CONCLUSIONS: Minimally invasive transthoracic device closure of the atrial septal defect at advanced age with a domestically made device without cardiopulmonary bypass is safe and feasible under transthoracic echocardiographic guidance. It was cost-savings, yielding better cosmetic results and leaving fewer traumas than surgical closure. Early and mid-term results are encouraging. However, it is necessary to evaluate the long-term results. BioMed Central 2011-09-29 /pmc/articles/PMC3195093/ /pubmed/21958758 http://dx.doi.org/10.1186/1749-8090-6-123 Text en Copyright ©2011 Zhang et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Zhang, Hui Chen, Qiang Chen, Liang-Wan Cao, Hua Zhang, Gui-Can Chen, Dao-Zhong Intraoperative device closure of atrial septal defects in the Older Population |
title | Intraoperative device closure of atrial septal defects in the Older Population |
title_full | Intraoperative device closure of atrial septal defects in the Older Population |
title_fullStr | Intraoperative device closure of atrial septal defects in the Older Population |
title_full_unstemmed | Intraoperative device closure of atrial septal defects in the Older Population |
title_short | Intraoperative device closure of atrial septal defects in the Older Population |
title_sort | intraoperative device closure of atrial septal defects in the older population |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195093/ https://www.ncbi.nlm.nih.gov/pubmed/21958758 http://dx.doi.org/10.1186/1749-8090-6-123 |
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