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Outcomes of Three Different Minimal Invasive Approaches for Secundum Atrial Septal Defect Closure: A Single Institute Experience

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Abstract

Objective: The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect (ASD). Methods: In this study, we reviewed clinical data for transcatheter occlusion (TCO, n=63), transthoracic occlusion (TTO, n=55), and right anterolateral minithoracotomy (RALT, n=60) techniques used for ASD closure. We compared the safety and efficacy of the three approaches. Results: ASD size in the TTO group was similar to that in the RALT group (P=0.645) and significantly larger than that in the TCO group (P<0.001). The RALT group had more non-central types of ASD than the TTO and TCO groups (P=0.019 and P<0.001). The operative time in the TTO group was shorter than that in the TCO and RALT groups (P<0.001 and P<0.001). The ventilation time and intensive care unit duration were shorter in the TTO group than in the RALT group (P<0.001 and P<0.001). Hospital duration in the TCO group was shorter than that in the TTO and RALT groups (P<0.001 and P<0.001). There were no residual shunt and mortality in any group in hospital or during follow-up. There was no significant difference in the incidence of total complications among the three groups (P=0.738). Conclusion: TCO, TTO, and RALT can be performed with favorable cosmetic and clinical results for closing ASD. Appropriate patient selection is an important factor for successful closure. These techniques are promising alternatives to standard median sternotomy and merit additional study.

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References

  1. Kaplan S. Congenital heart disease in adolescents and adults: natural and postoperative history across age groups. Cardiol Clin, 1993,11(4):543–556

    Article  CAS  PubMed  Google Scholar 

  2. Guo QK, Lu ZQ, Cheng SF, et al. Off-pump occlusion of trans-thoracic minimalinvasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: A single institute experience. J Cardiothorac Surg, 2011,6:48

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lloyd TR, Rao PS, Beekman RH, et al. Atrial septal defect occlusion with the buttoned device (a multi-institutional U.S. trial). Am J Cardiol, 1994,73(4):286–291

    Article  CAS  PubMed  Google Scholar 

  4. Perry SB, Van der Velde ME, Bridges ND, et al. Transcatheter closure of atrial and ventricular septal defects. Herz, 1993,18(2):135–142

    CAS  PubMed  Google Scholar 

  5. Berger F, Vogel M, Alexi-Meskishvili V, et al. Comparison of results and complications of surgical and Amplatzer device closure of atrial septal defects. J Thorac Cardiovasc Surg, 1999,118:674–680

    Article  CAS  PubMed  Google Scholar 

  6. Du ZD, Cao QL, Rhodes J, et al. Choice of device size and results of transcatheter closure of atrial septal defect using the Amplatzer septal occluder. J Interv Cardiol, 2002,15(4):287–292

    Article  PubMed  Google Scholar 

  7. Lancaster LL, Mavroudis C, Rees AH, et al. Surgical approach to atrial septal defect in female. Right thoracotomy versus sternotomy. Am Surg, 1990,56:218–221

    CAS  PubMed  Google Scholar 

  8. Massetti M, Babatasi G, Rossi A, et al. Operation for atrial septal defect through a right anterolateral thoracotomy: current outcome. Ann Thorac Surg, 1996, 62(4):1100–1103

    Article  CAS  PubMed  Google Scholar 

  9. Masura J, Gavora P, Formanek A, et al. Transcatheter closure of secundum atrial septal defects using the new self-centering Amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn, 1997,42(4):388–393

    Article  CAS  PubMed  Google Scholar 

  10. Thanopoulos BD, Laskari CV, Tsaousis GS, et al. Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol, 1998,31(5):1110–1116

    Article  CAS  PubMed  Google Scholar 

  11. Vasquez AF, Lasala JM. Atrial septal defect closure. Cardiol Clin, 2013,31(3):385–400

    Article  PubMed  Google Scholar 

  12. Tao L, Zeng XJ, Ma XJ, et al. The experience of occluding secundum atrial septal defect. Ann Thorac Surg, 2008,85(2):695

    Article  PubMed  Google Scholar 

  13. Hongxin L, Wenbin G, Lijun S, et al. Intraoperative device closure of secundum atrial septal defect with a right anterior minithoracotomy in 100 patients. J Thorac Cardiovasc Surg, 2007,134(4):946–951

    Article  PubMed  Google Scholar 

  14. Hijazi ZM, Cao Q, Patel HT, et al. Transesophageal echocardiographic results of catheter closure of atrial septal defect in children and adults using the Amplatzer device. Am J Cardiol, 2000,85(11):1387–1390

    Article  CAS  PubMed  Google Scholar 

  15. Sharafuddin MJA, Gu X, Titus JL, et al. Transvenous closure of secundum atrial septal defects: preliminary results with a new self-expanding Nitinol prosthesis in a swine model. Circulation, 1997,95(8):2162–2168

    Article  CAS  PubMed  Google Scholar 

  16. Abadir S, Sarquella-Brugada G, Mivelaz Y, et al. Advances in paediatric interventional cardiology since 2000. Arch Cardiovasc Dis, 2009,102(6–7):569–582

    Article  PubMed  Google Scholar 

  17. Rao PS. Transcatheter closure of atrial septal defect: are we there yet? J Am Coll Cardiol, 1998,31:1117–1119

    Article  CAS  PubMed  Google Scholar 

  18. Cardis E, Vrijheid M, Blettner M, et al. The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: estimates of radiation-related cancer risks. Radiat Res, 2007,167(4):396–416

    Article  CAS  PubMed  Google Scholar 

  19. Andreassi MG, Ait-Ali L, Botto N, et al. Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease. Eur Heart J, 2006,27(22):2703–2708

    Article  PubMed  Google Scholar 

  20. Fazel R, Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med, 2009,361(9):849–857

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ait-Ali L, Andreassi MG, Foffa I, et al. Cumulative patient effective dose and acute radiation-induced chromosomal DNA damage in children with congenital heart disease. Heart, 2010,96(4):269–274

    Article  PubMed  Google Scholar 

  22. Signorello LB, Mulvihill JJ, Green DM, et al. Stillbirth and neonatal death in relation to radiation exposure before conception: a retrospective cohort study. Lancet, 2010,376(9741):624–630

    Article  PubMed  PubMed Central  Google Scholar 

  23. Däbritz S, Sachweh J, Walter M, et al. Closure of atrial septal defects via limited right anterolateral thoracotomy as a minimal invasive approach in female patients. Eur J Cardiothorac Surg, 1999,15(1):18–23

    Article  PubMed  Google Scholar 

  24. Xu M, Zhu S, Wang X, et al. Two Different Minimally Invasive Techniques for Female Patients with Atrial Septal Defects: Totally Thoracoscopic Technique and Right Anterolateral Thoracotomy Technique. Ann Thorac Cardiovasc Surg, 2015,21(5):459–465

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Hao Hong, Long Wu, Xiao-ke Shang, Wei Su & Nian-guo Dong

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  1. Hao Hong
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  2. Long Wu
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  3. Xiao-ke Shang
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  4. Wei Su
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  5. Nian-guo Dong
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Correspondence to Nian-guo Dong.

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Conflict of Interest Statement

The authors have no conflicts of interest relevant to this article to disclose.

Author Nian-guo DONG is a member of the Editorial Board for [Current Medical Science]. The paper was handled by the other editor and has undergone rigorous peer review process. Author Nian-guo DONG was not involved in the journal’s review of, or decisions related to, this manuscript.

This work was supported by grants from the National Natural Science Foundation of China (No. 81873502 and No. 31330029).

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Hong, H., Wu, L., Shang, Xk. et al. Outcomes of Three Different Minimal Invasive Approaches for Secundum Atrial Septal Defect Closure: A Single Institute Experience. CURR MED SCI 41, 1225–1230 (2021). https://doi.org/10.1007/s11596-021-2466-3

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  • DOI: https://doi.org/10.1007/s11596-021-2466-3

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