Transcatheter Closure of Atrial Septal Defects in Adolescents and Adults: Technique and Diffculties

ABSTRACT: to evaluate the results of transcatheter closure of atrial septal defect (ASD) in adolescents and adult. Methods: a case series of patients undergoing transcatheter closure of ASD in RS Cipto Mangunkusumo, Jakarta during 2002 -2013. Transesophageal echocardiography, hemodynamic study, and angiography were performed before the procedure. Oxygen test was done if PA pressure was more than 2/3 of aortic pressure, followed by an occlusion test if no response observed to determine whether the device could be released. Results: we enrolled 54 patients, of whom 26% were adolescents and 3% were males. Median body weight was 49 (26-75) kg and ASD size was 21 (9.4-39.6) mm. The procedure was done under general anesthesia in 26% of patients. Oxygen test was applied in 11% patients and occlusion test in 2% of patient. Transcatheter closure of ASD was successful in all patients using common technique (31%), right pulmonary vein-assisted (65%), left pulmonary assisted (2%), and cutting long sheath (2%). There was neither residual ASD nor complications observed. Mean fluoroscopy and procedure time were 29 (SD 18) and 109 (SD 36) minutes, respectively. Median hospital stay was 1 (1-3) day. Conclusion: transcatheter closure of ASD in adolescents and adults is safe and effective.
Key words: transcatheter closure, atrial septal defect, device, oxygen test, occlusion test, pulmonary hypertension
Author: Mulyadi M. Djer, Nuvi N. Ramadhina, Nikmah S. Idris, Dedi Wilson, Idrus Alwi, Muhammad Yamin, Ika P. Wijaya
Journal Code: jpkedokterangg130263

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