ABSTRACT
Secondary atrial septal defect is one of the most common congenital heart diseases, and treatment is required in cases of large defects. The aim of this study was to assess the short-term results of secundum atrial septal defect closure by two surgery [right thoracotomy] and intervention [transcatheter Amplatzer septal occluder]. This is a descriptive study on 25 patients treated by one of the two above-mentioned methods at our center between 2004 and 2007. The patients underwent clinical and diagnostic examinations both before and after treatment such as chest X-ray, electrocardiography, echocardiography, catheterization, and angiography. The outcome and results were thereafter assessed and compared. The study population was comprised of 20 [80%] females and 5 [20%] males. The patients were divided into two groups: 17 [68%] patients were treated by intervention and 8 [32%] by right thoracotomy. The intervention group had a mean age of 12 years [ +/- 6years] and the surgery group 11 years [ +/- 4 years]. The average size of the defect was approximately 15 mm, which was similar in both groups. The average duration of hospital stay in the intervention group was significantly shorter than that of the surgery group, and the average cost of treatment in the intervention group was slightly less than the surgery group. One of the patients in the surgery group needed blood transfusion, and one of the patients in the intervention group suffered from Amplatzer embolization to the left ventricle, necessitating the extraction of the device through open heart surgery. One of the patients in the surgery group had a residual defect in the atrial septum, which was not significant. In light of the results of this study, it seems that in appropriately selected patients, the closure of the atrial septal defect via the interventional method is comparable to surgery
ABSTRACT
True aortic Stenosis is localized Protrusion of middle layer to it's lumen. That cause reducing of blood flow. If untreated serious complications may occur. The evaluation of follow-up results of coarctation treatment in patients admitted to Shaheed Rajaie Medical center Hospital between 1993 and 2004. This is a cross sectional study encompassing all the patients admitted to Shahid Rajaee Hospital with coarctation of aorta between 1993 and 2004. The data from the patients' files were extracted. Sixty-four cases [29.8%] were female and 145 cases [70.2%] were male. Mean age in the time of treatment was [6.51 +/- 9.91] yrs. Twenty-three cases [11%] were treated with balloon angioplasty; 177cases [84.7%] underwent surgical operations; and 9 cases [4.3%] have not been operated on in this center yet. Duration of follow up was 1 to 14 years. 5 cases died after treatment. Mean follow up was 3.72 years. During of follow up period, 25.4% became hypertensive that frequency of hypertension was significantly higher in older cases [P<0.05]. 67.5% had pressure gradient equal or more than 20mmHg by echocardiography. 30 cases [14.3%] had recoarctation by catheterization [26 cases after surgery and 4 cases after native balloon angioplasty]; there was no relation between age and this variable. On the basis of results of this and same studies treatment of coarctation in lower age had lower frequency of hypertension and about effect of treatment in lower ages and higher frequency of recoarctation there is controversy