@Article{CHD.2020.011249,
AUTHOR = {Amira Nour, Heba Kamel, Yasmeen Abdelrazik, Khaled Shams, Noha Gamal, Safaa Huessin, Alaa Roushdy, Maiy El Sayed},
TITLE = {Safety and Efficacy of Transcatheter Closure of Atrial Septal Defects in Everyday Practice. A Multicenter Study in a Developing Country},
JOURNAL = {Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {2},
PAGES = {79--87},
URL = {http://www.techscience.com/chd/v15n2/39428},
ISSN = {1747-0803},
ABSTRACT = {Background: Transcatheter closure of secudum atrial septal defect (ASD)
has gained wide acceptance since its introduction more than 3 decades ago. Safety
and efficacy of the procedure in everyday practice needs continuous update.
Objective: The aim of the study is to determine the incidence of complications and
identify everyday management protocols. Methods: This is a prospective
nonrandomized study including all the patients with Secundum ASD or fenestrated
IAS referred to two different congenital heart diseases centers in Ain Shams
university and sohag university in Egypt over 2 years with an indication for closure
according to American and European guidelines. A custom-made sheet was made to
include all relevant demographic and procedural data as well as any intra or
periprocedural complications. Results: This study evaluated 330 patients over a
period of 2 years. Most of the patients were in pediatric age group where the mean
age was 12 +/– 13 years, mean weight of 40 +/– 15 kg, the mean device diameter used
was 20 +/– 7.7 mm. The procedure was successful in 326, four patients required 2
simultaneous devices, and another three adult patients underwent simultaneous
percutaneous coronary intervention (PCI). There were 26/330 (7.7%) complications,
only one was life threating complication (0.3%); a LA appendage perforation which
was managed surgically. The remaining complications were either major or minor,
the most common was arrhythmia in 7 patients (2.3%), followed by device
embolization in 5 patients (1.5%) all of them were retrieved percutaneously except
one which was removed surgically. Four patients (1.2%) developed thrombus either
on the right atrial side or LA side or both, managed successfully by anti-coagulation,
similarly another four patients (1.2%) had pericardial effusion +/– hemopericardium,
one of which was due to erosion of the left atrial roof while none of our patients had
residual shunts. Two patients had anesthesia related complications, one patient
developed nickel allergy and one patient had vascular complication. Conclusion: Although transcatheter ASD closure is a safe and effective procedure, but a wide range of complications should be anticipated and managed properly. In high volume
centers with proper patient selection, complications could be significantly reduced
but not completely abolished.},
DOI = {10.32604/CHD.2020.011249}
}