Wagdi Philipp
HerzZentrum Hirslanden, Witellikerstrasse 36, 8008 Zurich, Switzerland. Email:
Cardiol Res. 2011 Feb;2(1):7-15. doi: 10.4021/cr17w. Epub 2011 Jan 20.
Percutaneous closure of interatrial septal communications (IASC) is generally being regarded as a safe and straightforward intervention. Reporting and classification of adverse events (AE) as is the case for percutaneous coronary intervention (PCI) is not standardized. Also, the focus of reported larger studies has not been primarily on AE and strategies to avoid them.
The data of all 112 consecutive patients undergoing IASC by a single operator were reviewed. In analogy to classification for PCI, an AE was considered to be major if any of the following occurred: death, major or minor stroke, myocardial infarction, the need for an originally unplanned additional surgery or intervention or blood transfusion. Every AE and how it may have been avoided is reviewed in detail.
Major AE according to the suggested classification occurred in 2.7% of patients, including tamponade in 1 patient necessitating thoracotomy 7 months after IASC, percutaneous retrieval of an embolized device in 1 patient, and ambulatory same day surgical treatment of an arteriovenous fistula in 1 patient.
The proposed new classification of AE provides a unified and comparable approach for IASC procedures. Retrospectively, two of the 3 major AE could have probably been avoided by more thoughtful patient and material selection.
经皮闭合房间隔交通（IASC）通常被视为一种安全且直接的干预措施。与经皮冠状动脉介入治疗（PCI）一样，不良事件（AE）的报告和分类并未标准化。此外，已发表的大型研究的重点并非主要放在不良事件及其预防策略上。
回顾了由一名操作者连续进行IASC的所有112例患者的数据。类似于PCI的分类，如果发生以下任何一种情况，则AE被视为严重：死亡、严重或轻微中风、心肌梗死、需要进行原计划外的额外手术或干预或输血。详细回顾了每例AE及其可能的避免方法。
根据建议分类，2.7%的患者发生了严重AE，包括1例IASC术后7个月发生心包填塞需开胸手术，1例患者经皮取出栓塞装置，1例患者门诊当天对动静脉瘘进行手术治疗。
所提议的AE新分类为IASC手术提供了一种统一且可比的方法。回顾性分析表明，通过更谨慎地选择患者和材料，3例严重AE中的2例可能可以避免。
