Department of Pediatrics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Department of Pediatrics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2018 Jul;34(7):363-369. doi: 10.1016/j.kjms.2018.05.001. Epub 2018 May 30.
Atrial septal defect (ASD) is one of the two most common congenital heart diseases in children and adult. After the application of catheter intervention for ASD, this became an alternative treatment other than surgery from late 1990. In 2001, the procedure was further approved by the US Food and Drug Administration (FDA), and become the first choice for most cases of secundum type of ASD worldwide. The success rate is more than 98% in literature reviews, with low complication rates in percutaneous ASD closure. Major complications are around 1%, including device embolization, cardiac erosions, new-onset atrial arrhythmia, and other comorbidities. We reviewed indications for percutaneous secundum type ASD closure, technique, successful rate and major complications in this article. To complete the catheter intervention with difficult ASD conditions, various procedural techniques have been developed recently. We also report a challenging case by a current balloon-assisted technique for huge ASD closure.
房间隔缺损(ASD)是儿童和成人中最常见的两种先天性心脏病之一。自 20 世纪 90 年代末以来,经导管介入治疗 ASD 已成为手术之外的另一种治疗选择。2001 年,该方法得到美国食品和药物管理局(FDA)的进一步批准,并成为全球大多数继发型 ASD 的首选治疗方法。文献回顾显示,该手术成功率超过 98%,经皮 ASD 封堵术的并发症发生率较低。主要并发症约为 1%,包括器械栓塞、心脏侵蚀、新发房性心律失常和其他合并症。本文回顾了经皮继发型 ASD 封堵的适应证、技术、成功率和主要并发症。为了完成具有挑战性的 ASD 条件的导管介入,最近已经开发了各种手术技术。我们还报告了一个具有挑战性的病例,采用当前的球囊辅助技术来完成巨大 ASD 的封堵。