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Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country

Introduction: This study compares the effectiveness and cost of trans-catheter verses surgical closure of secundum atrial septum defect (ASD). ASD accounts for 10% of congenital cardiac defects. Trans-catheter closure of secundum ASD is increasingly used as the primary intervention. Surgical repair...

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Autores principales: Siddiqui, Waleed T, Usman, Tariq, Atiq, Mehnaz, Amanullah, Muhammad Muneer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tabriz University of Medical Sciences 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291597/
https://www.ncbi.nlm.nih.gov/pubmed/25610550
http://dx.doi.org/10.15171/jcvtr.2014.013
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author Siddiqui, Waleed T
Usman, Tariq
Atiq, Mehnaz
Amanullah, Muhammad Muneer
author_facet Siddiqui, Waleed T
Usman, Tariq
Atiq, Mehnaz
Amanullah, Muhammad Muneer
author_sort Siddiqui, Waleed T
collection PubMed
description Introduction: This study compares the effectiveness and cost of trans-catheter verses surgical closure of secundum atrial septum defect (ASD). ASD accounts for 10% of congenital cardiac defects. Trans-catheter closure of secundum ASD is increasingly used as the primary intervention. Surgical repair is advised in a proportion of secundum type defects which are unsuitable for device closure. Methods: We reviewed the clinical course of 176 patients who underwent closure of isolated secundum ASD. The patients were assigned to either the device or surgical group depending upon the treatment they received. Successful closure was assessed immediately after the procedure. The following outcomes were studied: mortality, morbidity, hospital stay, and costs. Results: Ninety five patients were in the surgical group and 81 patients were in the group undergoing device closure. The median age was 14.0 years (range 1.1-61.0) for surgical group and 24.0 years (range 0.5-68.0) for the device group. The mortality in both groups was 0. The procedure success rate was 100% for the surgical group and 96.3% for the device group. The complication rate was 13.7% for surgical group and 7.4% for the device group. The mean length of hospital stay was 5.0 ± 2.7 days for surgical group and 3.0 ± 0.4 days for device group. The procedure cost for surgery was found to be 12.3% lower than that of trans-catheter closure. Conclusion: Successful closure is achieved by both methods. Trans-catheter closure results in lower rate of complication and hospital stay but the cost of the procedure tends to be higher than surgery.
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spelling pubmed-42915972015-01-21 Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country Siddiqui, Waleed T Usman, Tariq Atiq, Mehnaz Amanullah, Muhammad Muneer J Cardiovasc Thorac Res Original Article Introduction: This study compares the effectiveness and cost of trans-catheter verses surgical closure of secundum atrial septum defect (ASD). ASD accounts for 10% of congenital cardiac defects. Trans-catheter closure of secundum ASD is increasingly used as the primary intervention. Surgical repair is advised in a proportion of secundum type defects which are unsuitable for device closure. Methods: We reviewed the clinical course of 176 patients who underwent closure of isolated secundum ASD. The patients were assigned to either the device or surgical group depending upon the treatment they received. Successful closure was assessed immediately after the procedure. The following outcomes were studied: mortality, morbidity, hospital stay, and costs. Results: Ninety five patients were in the surgical group and 81 patients were in the group undergoing device closure. The median age was 14.0 years (range 1.1-61.0) for surgical group and 24.0 years (range 0.5-68.0) for the device group. The mortality in both groups was 0. The procedure success rate was 100% for the surgical group and 96.3% for the device group. The complication rate was 13.7% for surgical group and 7.4% for the device group. The mean length of hospital stay was 5.0 ± 2.7 days for surgical group and 3.0 ± 0.4 days for device group. The procedure cost for surgery was found to be 12.3% lower than that of trans-catheter closure. Conclusion: Successful closure is achieved by both methods. Trans-catheter closure results in lower rate of complication and hospital stay but the cost of the procedure tends to be higher than surgery. Tabriz University of Medical Sciences 2014 2014-12-30 /pmc/articles/PMC4291597/ /pubmed/25610550 http://dx.doi.org/10.15171/jcvtr.2014.013 Text en © 2014 The Author(s) This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Siddiqui, Waleed T
Usman, Tariq
Atiq, Mehnaz
Amanullah, Muhammad Muneer
Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country
title Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country
title_full Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country
title_fullStr Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country
title_full_unstemmed Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country
title_short Transcatheter Versus Surgical Closure of Atrial Septum Defect: A Debate from a Developing Country
title_sort transcatheter versus surgical closure of atrial septum defect: a debate from a developing country
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291597/
https://www.ncbi.nlm.nih.gov/pubmed/25610550
http://dx.doi.org/10.15171/jcvtr.2014.013
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