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J Card Surg. 2011 May;26(3):254-8. doi: 10.1111/j.1540-8191.2011.01249.x. Epub 2011 Apr 11.
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Atrial septal defect: waiting for symptoms remains an unsolved medical anachronism.房间隔缺损：等待症状出现仍是一个尚未解决的医学过时做法。
Eur Heart J. 2011 Mar;32(5):531-4. doi: 10.1093/eurheartj/ehq377. Epub 2010 Oct 22.
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Comparison of clinical outcomes and cost between surgical and transcatheter device closure of atrial septal defects in Singapore children.新加坡儿童房间隔缺损经导管介入封堵术与外科手术治疗的临床结局和成本比较。
Ann Acad Med Singap. 2010 Aug;39(8):629-33.
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Outcomes in patients with pulmonary hypertension undergoing percutaneous atrial septal defect closure.接受经皮房间隔缺损封堵术的肺动脉高压患者的治疗结果。
Heart. 2008 Sep;94(9):1189-93. doi: 10.1136/hrt.2006.114660. Epub 2007 Oct 11.
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Surgical versus percutaneous occlusion of ostium secundum atrial septal defects: results and cost-effective considerations in a low-income country.继发孔型房间隔缺损的手术封堵与经皮封堵：低收入国家的结果及成本效益考量
J Am Coll Cardiol. 2006 Jan 17;47(2):326-31. doi: 10.1016/j.jacc.2005.06.086.
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Percutaneous versus surgical closure of secundum atrial septal defect: comparison of early results and complications.继发孔型房间隔缺损的经皮封堵术与外科手术封堵术：早期结果及并发症比较
Am Heart J. 2006 Jan;151(1):228-34. doi: 10.1016/j.ahj.2005.02.051.
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Prevalence of congenital heart disease.先天性心脏病的患病率。
Am Heart J. 2004 Mar;147(3):425-39. doi: 10.1016/j.ahj.2003.05.003.
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The gold standard for atrial septal defect closure: current surgical results, with an emphasis on morbidity.房间隔缺损封堵的金标准：当前手术结果，重点关注发病率。
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Surgical closure of atrial septal defects in adults: effect of age at operation on outcome.成人房间隔缺损的手术闭合：手术年龄对预后的影响。
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经导管封堵与外科手术封堵房间隔缺损：来自一个发展中国家的争论

Transcatheter versus surgical closure of atrial septum defect: a debate from a developing country.

作者信息

Siddiqui Waleed T, Usman Tariq, Atiq Mehnaz, Amanullah Muhammad Muneer

机构信息

Dow University of Health Sciences, Karachi, Pakistan.

Department of Cardiothoracic Surgery, The Aga Khan University Hospital (AKUH), Karachi, Pakistan.

出版信息

J Cardiovasc Thorac Res. 2014;6(4):205-10. doi: 10.15171/jcvtr.2014.013. Epub 2014 Dec 30.

DOI:10.15171/jcvtr.2014.013
PMID:25610550
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4291597/
Abstract

INTRODUCTION

This study compares the effectiveness and cost of trans-catheter verses surgical closure of secundum atrial septum defect (ASD). ASD accounts for 10% of congenital cardiac defects. Trans-catheter closure of secundum ASD is increasingly used as the primary intervention. Surgical repair is advised in a proportion of secundum type defects which are unsuitable for device closure.

METHODS

We reviewed the clinical course of 176 patients who underwent closure of isolated secundum ASD. The patients were assigned to either the device or surgical group depending upon the treatment they received. Successful closure was assessed immediately after the procedure. The following outcomes were studied: mortality, morbidity, hospital stay, and costs.

RESULTS

Ninety five patients were in the surgical group and 81 patients were in the group undergoing device closure. The median age was 14.0 years (range 1.1-61.0) for surgical group and 24.0 years (range 0.5-68.0) for the device group. The mortality in both groups was 0. The procedure success rate was 100% for the surgical group and 96.3% for the device group. The complication rate was 13.7% for surgical group and 7.4% for the device group. The mean length of hospital stay was 5.0 ± 2.7 days for surgical group and 3.0 ± 0.4 days for device group. The procedure cost for surgery was found to be 12.3% lower than that of trans-catheter closure.

CONCLUSION

Successful closure is achieved by both methods. Trans-catheter closure results in lower rate of complication and hospital stay but the cost of the procedure tends to be higher than surgery.

摘要

引言

本研究比较了经导管封堵与手术闭合继发孔型房间隔缺损（ASD）的有效性和成本。ASD占先天性心脏缺陷的10%。经导管闭合继发孔型ASD越来越多地被用作主要干预措施。对于一部分不适合器械封堵的继发孔型缺损，建议进行手术修复。

方法

我们回顾了176例接受孤立性继发孔型ASD闭合术患者的临床病程。根据患者接受的治疗，将其分为器械组或手术组。术后立即评估封堵是否成功。研究了以下结果：死亡率、发病率、住院时间和成本。

结果

手术组95例患者，器械封堵组81例患者。手术组的中位年龄为14.0岁（范围1.1 - 61.0岁），器械组为24.0岁（范围0.5 - 68.0岁）。两组的死亡率均为0。手术组的手术成功率为100%，器械组为96.3%。手术组的并发症发生率为13.7%，器械组为7.4%。手术组的平均住院时间为5.0±2.7天，器械组为3.0±0.4天。发现手术的费用比经导管封堵低12.3%。

结论

两种方法均能成功闭合。经导管封堵导致较低的并发症发生率和住院时间，但手术费用往往高于手术。