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Objective: To analyze the impact factors of occluder choice for transcatheter closure of adult large atrial septal defect (ASD). Methods: Data of 65 patients with large ASD were retrospectively analyzed. The relationships of occluder choice for transcatheter closure of ASD and the diameter, shape and edge of defect were observed. Results: ASD in all patients were successfully occluded, with 40 mm diameter occluders in 26 cases, 42 mm diameter occluders in 24 cases and ≥ 44 mm diameter occluders in 15 cases. There was no difference of defect maximum diameter (Dmax), minimum diameter (Dmin), Dmin/Dmax nor the added value of occluder (all P>0.05) among the above three, whereas there were statistical differences of Dmax, Dmin and the added value of Dmin/Dmax<0.80 (n=24) and ≥0.80 (n=41) occluders (all P<0.05). Meanwhile, significant differences of diameter and the added value of occluders were noticed between patients with distance of defect aortic margin or posterior inferior margin <5 mm (n=45) and those ≥5 mm (n=20, all P<0.05). Conclusion: For intervention treatment of adult large ASD, the diameter, shape and edge of defect are the impact factors of choice of occluder.
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Objective@#To compare the efficacy and safety of Cardi-O-fix patent foramen ovale (PFO) occluder and Amplatzer PFO occluder for the treatment of patients with PFO.@*Methods@#A total of 246 consecutive patients (105 males and 141 females) with PFO were prospectively enrolled from May 30, 2013 to March 30, 2015 in our hospital. PFO interventional closure was applied according to the anatomical structure of the disease and patients′ wishes.Cardi-O-fix PFO occluder was used in 180 cases (COF group), Amplatzer PFO occluder was used in the remaining 66 cases (Amp group). Post-procedure safety including recurrent stroke, transient ischemic attack, death, and complete closure rate, and efficacy including procedure related complications of different devices were compared during the 12 months follow-up.@*Results@#(1) Rate of transient ischemic attack was similar between COF group and Amp group at 12 months after procedure(1.1%(2/180) vs. 1.5%(1/66), P=1.000). There was no recurrent stroke and death during the 12 months follow-up period.Complete closure rate was similar between COF group and Amp group at 12 months after the procedure(90.6%(163/180)vs. 86.4%(57/66), P=0.355). (2) Three cases(1.7%) of paroxysmal atrial fibrillation were observed in COF group during the 12 months follow-up period, 1 patient converted spontaneously to sinus rhythm and 2 patients received successful pharmacologic conversion and converted to sinus rhythm. One patient(1.5%)developed paroxysmal atrial fibrillation and was pharmacologically converted to sinus rhythm in the Amp group. There was no significant difference in rate of paroxysmal atrial fibrillation between the two groups(P=1.000). There was no complications such as occluder translocation, erosion, pericardial effusion and puncture site bleeding in the 2 groups during the 12 months follow-up.@*Conclusion@#Efficacy and safety are similar for PFO treatment with Cardi-O-fix PFO occluder or Amplatzer PFO occluder in this patient cohort.
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<p><b>OBJECTIVE</b>To observe the effect of oversized occluder on endothelialization post percutaneous closure of experimental atrial septal defect (ASD) in dogs.</p><p><b>METHODS</b>ASD was established with the help of transthoracic echocardiography in 18 dogs. ASD size was (6.0 ± 0.2) mm. Dogs were randomly divided into normal size group (implanted with 8 mm occlude, n = 9) and oversized group (implanted with 12 mm occluder, n = 9). Dogs were randomly killed at 3, 6 and 14 months after percutaneous closure. The endothelialization process on device surface was observed by scanning electron microscope.</p><p><b>RESULTS</b>Four animals died around 1 month post procedure. Microscopic sections from normal group showed nearly complete endothelialization at 3 months after device implantation and complete endothelialization at 6 and 14 months after device implantation. While microscopic sections showed lack of endothelialization at 3 months post implantation, nearly endothelialization at 6 months, and complete endothelialization at 14 months after device implantation in oversized group.</p><p><b>CONCLUSION</b>Incomplete endothelialization of occluder surface is observed at 6 months after implantation of an oversized ASD occluder device in this model.</p>
Subject(s)
Animals , Dogs , Echocardiography , Heart Septal Defects, Atrial , Diagnostic Imaging , Therapeutics , Percutaneous Coronary Intervention , Septal Occluder DeviceABSTRACT
Objective To investigate the algorithm and efficacy of interventional treatment for combined congenital heart diseases. Methods Thirty-four patients (12 males and 22 females) with combined congenital heart disease underwent simultaneous transcatheter therapy. The types of the congenital heart defect combination were as follow: ASD and PS (16 cases); ASD and VSD (7 cases); ASD and PDA (3 cases); ASD and MS (2 cases); VSD and PDA (3 cases); Taussig-Bing and PDA(1 case); PDA, ASD and PS (1 case); ASD, VSD and PDA (1 case). The algorithm of transcatheter intervention was: PBPV or PBMV at first followed by the occlusion of VSD, PDA and ASD successively. Transthoracic echocardiography (TTE) and X-ray examination were done 3d, 1 m and 3 m after the procedure to evaluate the outcome of the procedure. Results All patients were treated successfully at one time. No complications occurred during and immediately after the procedure. There was no residual shunt and all the occlusion devices were found in the suitable site evaluated by means of TTE and X-ray right after the procedure. In 16 patients with ASD and PS, the systolic pressure across the pulmonary valve decreased from (53?20) mm?Hg to (14?10) mm?Hg (P
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Objective To evaluate the clinical effect of interventional occlusion for atrial septal defect(ASD) with domestic occluder by X-ray in combination with echocardiography.Methods 38 patients with ASD were all implanted with domestic occluder.The imageological data before and 6 months after treatment were analysed and compared.Results There were no residual shunts after interventional treatment.The heart surface area,right inferior pulmonary artery diameter,the base lines of pulmonary cone,the diameters of pulmonary trunk and the degree of protrusion of pulmonary cone were all decreased after operation(P