University of Colorado, Anschutz Medical Campus, Mail Stop B132, Leprino Office Building, 12401 East 17th Avenue, Room 524, Aurora, CO, 80045, USA.
Curr Cardiol Rep. 2018 Apr 17;20(6):37. doi: 10.1007/s11886-018-0983-x.
While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up.
With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published. While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.
虽然经皮 ASD 封堵术的安全性和有效性已得到证实，但最近有新数据显示，左心结构介入治疗后残余的医源性 ASD（iASD）会产生负面影响。此外，最近还研究了具有潜在优势的新型装置。我们将在此回顾 iASD 封堵的潜在适应证，以及新一代封堵装置和可能需要长期随访的潜在迟发性并发症。
随着左心结构介入治疗和大口径经房间隔穿刺技术的扩展，人们对残余 iASD 的管理经验不断增加。最近的一些报告表明，这些手术后残余的 iASD 可能是临床结果和死亡率下降的潜在原因。此外，最近还公布了一些关于新一代封堵装置的试验以及经皮 ASD 封堵后迟发性并发症的相关知识。虽然经皮 ASD 封堵术不再是一种治疗间隔缺损的新方法，但大口径经房间隔穿刺和新一代装置后残余 iASD 仍存在一些当代问题，这促使我们进行了本次综述。显然，需要持续关注潜在的迟发性并发症，并通过不断研究降低其发生率。
