Key result
Deficient SVC rim and larger device-to-length ratio predict prolonged percutaneous ASD closure, occurring in ~31%.
Why the study?
Percutaneous transcatheter closure of atrial septal defect can become a prolonged procedure, and the predictors of procedure time prolongation needed to be identified.
Observational (n=81)
Retrospective study identifies anatomical and device size predictors of prolonged transcatheter atrial septal defect closure in children, highlighting key risk factors for complex deployments.
Background: Percutaneous transcatheter closure (PTCC) of atrial septal defect (ASD) may convert to a long procedure.We aimed to identify predictors of prolonged procedure.Methods: Under transesophageal echocardiography and fluoroscopy guidance, 81 children with ASD underwent PTCC.Retrospectively, medical charts, echocardiographic recordings, catheterization reports and fluoroscopic films were reviewed.Demographics, echocardiographic measurements of ASD, dimensions of the device and hemodynamic data were collected.Prolonged procedure was defined as the duration from device deployment out of the delivery sheath to its release exceeding 10 minutes.A statistical model was designed using stepwise logistic regression analysis.Receiver operating characteristic curves were plotted to find the best cut-off for significant predictors.Results: The procedure was prolonged in 25 patients.By monovariate analysis, the significant predictors for prolonged procedure were smaller, and younger patients, larger ASD, smaller left atrial (LA) dimensions and device waist ratios to weight, patient's length, and LA dimensions.By multivariate analysis, the significant predictors were deficient septal rim toward superior vena cava (SVC) and device waist diameter in relation to patient's length (best cut-off: < 12 mm and > 0.13, respectively).In three cases (3.7%) the device embolized; retrospectively possibly the cause is small used device Predictors of Procedure Time Prolongation During Percutaneous
No takes yet. Share an insight, caveat, or question.
El‐Segaier et al. (2018) conducted an observational in Atrial septal defect (ASD) (n=81). Percutaneous transcatheter closure (PTCC) of ASD / Anatomical and device size predictors was evaluated on Prolonged procedure (defined as duration from device deployment out of the delivery sheath to its release exceeding 10 minutes). Deficient septal rim toward the SVC (<12 mm) and device waist diameter-to-patient length ratio (>0.13) independently predicted prolonged percutaneous ASD closure, which occurred in 30.9% (25/81).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: