Experience on transthoracic occlusion of atrial septal defect / 中国微创外科杂志

ABSTRACT

30 mm in 100 patients.The ASD was associated with atrial septal aneurysm in 2 patients.An incision 2~3 cm in length was made in the 4th intercostal space of the right parasternum to expose the right atrium,at which a purse-string suture was placed.A double-lumen delivery catheter was then punctured into the right atrium,and passed through the defect to the left atrium under the guidance of transesophageal echocardiography.An occluder made of a nickel-titanium metal alloy and 4 mm bigger than the defect was released to engage on the defect.The delivery catheter was then withdrawn.Results The operation was successfully accomplished in all the 206 patients.The operation time was 18~32 min(mean,26?7 min). No surgery-related death happened and no occluder dislodgment occurred.Mechanical ventilation was stopped at 5 hours after operation,and all the patients got out of bed on the operation day.Colour Doppler imaging 3 days after operation showed complete occlusion of the ASD without residual shunt.The length of hospitalization was 4?2 days.Follow-up examinations for 6 months in 186 patients and for 3~4.5 years in 57 patients by using Colour Doppler imaging revealed no residual shunt and normal cardiac functions.Conclusions Mini-incision transthoracic occlusion of atrial septal defect is safe and reliable in patients contraindicated to transcatheter closure.