Percutaneous closure of secundum atrial septal defects: Experience of a tertiary referral center

Yıl 2012, Cilt: 39 Sayı: 1, 97 - 101, 01.03.2012

Oktay Ergene Cem Nazlı Uğur Kocabaş Hamza Duygu Nihan Kahya Eren Zehra İlke Akyıldız Ali Hikmet Kırdök Rida Berilgen

https://doi.org/10.5798/diclemedj.0921.2012.01.0103

Öz

Objectives: This study was aimed to evaluate our clinical experiences and investigate results of percutaneous clo-sure of secundum atrial septal defects (ASD) in our clinic. Results: We retrospectively included 70 patients (19 male, 51 female) undergoing percutaneous ASD closure proce-dure with mean age of 36±14.8 (17-75) in our clinic between March 2008 and January 2010. Defect diameter meas-ured by transesophageal echocardiography was 19.7±6.3 mm (6-32 mm). Device size used for percutaneous closure of ASD was 23.7±6.2 (12-36). Devices used for percutaneous closure were nitinol-based devices including Amplatzer (64.7%), Cardiofix (26.7%) and biodegredable BioStar (8.6%). The percutaneous closure procedure was successful at 68 of 70 (97%) patients. In 2 patients procedure failed. Failure reason was device embolization in one patient and device strut fracture in other; so these 2 patients referred to surgery. During follow up 2 more patients also referred to surgery because of device embolization in first day control. In 3 patients (4.2%) supraventricular arrythmias that are converted to sinus by cardioversion are observed. Mean follow up interval was 18.6±9.6 months (1-44) and during this period peripheral vascular complications, cerebrovascular accidents, thrombus on devices, device erosion or death is not observed. Conclusion: Percutaneous closure of secundum ASD which started to replace surgical treatment of ASD in last dec-ades is safe and effective method in short to mid-term period. However because of potentially serious complication risks it should be performed in special centers by operators who are experienced in treating structural heart diseases.

Anahtar Kelimeler

Atrial septal defect, percutaneous closure, clinical outcome

Percutaneous closure of secundum atrial septal defects: Experience of a tertiary referral center

Öz

Amaç: Bu çalışmada, kliniğimizde perkütan yolla atrial septal defekt (ASD) kapatılması işlemi uygulanan hastalara ait klinik deneyimimizin ve sonuçlarının değerlendirilmesi amaçlanmıştır. Bulgular: Çalışmaya kliniğimizde, Mart 2008-Ocak 2010 tarihleri arasında perkütan yolla ASD kapatılması işlemi uy-gulanan ortalama yaşı 36±14,8 olan (17-75) yıl olan 70 hasta (19 erkek, 51 kadın) retrospektif olarak alındı. Hastala-rın transözofajial ekokardiyografi ölçümlerinde ASD çapı 19,7±6,3 mm (6-32 mm) olarak ölçüldü. Perkütan kapatma-da kullanılan cihaz çapları 23,7±6,2 (12-36) olarak saptandı. ASD kapatma cihazı olarak nitinol bazlı cihazlardan Amplatzer %64,7, Cardiofix %26,7 oranında ve biodegredable BioStar %8,6 oranında kullanıldı. Yetmiş hastadan 68\'inde (%97) işlem başarılı oldu. Bir hastada işlem esnasında cihaz embolisi, 1 hastada ise cihazda strut kırığı ol-ması nedeniyle hastalar cerrahiye verildi. Takipte 2 hastada 1. gün kontrolünde cihaz embolizasyonu saptandı. Üç hastada (%4,2) kardiyoversiyon ile sinus ritmine çevrilen supraventriküler aritmi izlendi. Hastalar ortalama 18,6±9,6 ay (1 ay- 44 ay) boyunca izlendi. Takipte hastalarda cihaz üzerinde thrombüs, cihaz erozyonu, periferik vasküler komplikasyon, serebro vasküler olay veya ölüm izlenmedi. Sonuç: Sekundum ASD\'lerin perkütan kapatılması son yıllarda cerrahinin yerini almaya başlayan kısa ve orta vadede güvenli, etkin bir tedavi şeklidir. İşlemin potansiyel ciddi olabilecek komplikasyonları nedeniyle yapısal kalp hastalıkla-rının tedavisinde uzmanlaşmış; tecrübeli merkezlerde yapılması hususuna dikkat edilmelidir.

Anahtar Kelimeler

Atrial septal defekt, perkütan kapatma, klinik sonuçlar

Kaynakça

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