Oto M Ali, Aytemir Kudret, Ozkutlu Süheyla, Kaya Ergün Barış, Kabakcı Giray, Ateş Ahmet Hakan, Yorgun Hikmet, Canpolat Uğur
Department of Cardiology, Medicine Faculty of Hacettepe University, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2011 Jul;39(5):385-95. doi: 10.5543/tkda.2011.01474.
We evaluated short- and mid-term results of percutaneous closure of atrial septal defects (ASD) and patent foramen ovale (PFO) using various closure devices.
The study included 278 patients (128 men, 150 women; mean age 39±12 years; range 17 to 66 years) who underwent percutaneous closure of secundum ASD (n=134) or PFO (n=144). All the patients were assessed by transthoracic (TTE) and transesophageal (TEE) echocardiography before the procedure. Percutaneous closure was performed with the Amplatzer (n=180), Occlutech Figulla (n=92) or BioSTAR (n=6) devices. Closure of ASDs was performed under general anesthesia with TEE guidance, and closure of PFOs was performed under local anesthesia with TTE guidance. Follow-up controls were at 1, 6, and 12 months, and annually thereafter. The mean follow-up period was 35.1 ± 24.6 months for ASD cases, and 24.9 ± 15.5 months for PFO cases.
The mean device size was 20.2 ± 5.6 mm for ASD cases and 24 ± 2.9 mm for PFO cases. The mean procedural and fluoroscopy times were 28.4 ± 6.1 min and 4.9 ± 2.1 min for ASD closure, and 18.2 ± 5.3 min and 3.6 ± 1.2 min for PFO closure, respectively. Procedural device embolization occurred in only one patient. No recurrent embolic events occurred after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two patients during the procedure and in one patient at one-year follow-up.
Percutaneous closure of secundum ASDs and PFOs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an effective and safe treatment option.
我们评估了使用各种封堵装置经皮闭合房间隔缺损(ASD)和卵圆孔未闭(PFO)的短期和中期结果。
该研究纳入了278例患者(128例男性,150例女性;平均年龄39±12岁;范围17至66岁),他们接受了继发孔型ASD(n = 134)或PFO(n = 144)的经皮闭合。所有患者在手术前均通过经胸(TTE)和经食管(TEE)超声心动图进行评估。使用Amplatzer(n = 180)、Occlutech Figulla(n = 92)或BioSTAR(n = 6)装置进行经皮闭合。ASD的闭合在全身麻醉下经TEE引导进行,PFO的闭合在局部麻醉下经TTE引导进行。随访在术后1、6和12个月进行,此后每年进行一次。ASD病例的平均随访期为35.1±24.6个月,PFO病例为24.9±15.5个月。
ASD病例的平均封堵器尺寸为20.2±5.6 mm,PFO病例为24±2.9 mm。ASD闭合的平均手术时间和透视时间分别为28.4±6.1分钟和4.9±2.1分钟,PFO闭合分别为18.2±5.3分钟和3.6±1.2分钟。仅1例患者发生手术中封堵器栓塞。PFO闭合后未发生复发性栓塞事件,ASD闭合后未见残余分流。2例患者在手术过程中及1例患者在1年随访时发生封堵器血栓形成。
使用Amplatzer、Occlutech Figulla和BioSTAR装置经皮闭合继发孔型ASD和PFO是一种有效且安全的治疗选择。