Key result
ASD device closure matches surgical repair with 100% success alongside shorter operative times and hospital stays.
Why the study?
Transcatheter and intraoperative device closure are used to reduce incision size and cardiopulmonary bypass injury, but no studies had compared the safety and efficiency of these three treatments.
Do transcatheter and intraoperative device closure improve procedural efficiency and recovery times compared to surgical repair in patients with isolated atrial septal defect?
Cohort (n=87)
No
Do transcatheter and intraoperative device closure improve procedural efficiency and recovery times compared to surgical repair in patients with isolated atrial septal defect?
Transcatheter and intraoperative device closure for isolated ASD offer similar efficacy and safety to surgical repair but with significantly shorter recovery times, supporting transcatheter closure as the preferred first-line approach.
Answers are grounded in this paper and cite their sources.
Device closure may shorten ASD recovery; leaves open need for RCTs before practice change.
BACKGROUND: Transcatheter and intraoperative device closure for atrial septal defect (ASD) are widely applied to reduce the incision size and the potential for injury during cardiopulmonary bypass (CPB) in conventional surgical repair. No studies had been conducted to compare the safety and efficiency of these three treatments. METHODS: From January 2018 to April 2018, 87 patients with an isolated ASD who had undergone transcatheter device closure (n = 45), intraoperative device closure (n = 22) and surgical repair (n = 20) were retrospectively reviewed and further analyzed to compare these three treatments. RESULTS: The successful closure rate was similar in the three groups. There was a significant difference in aortic cross-clamping time, CPB duration and operative time between the surgical group and the device groups. The length of intensive care unit stay, postoperative mechanical ventilation time and length of hospital stay were shorter in the two device groups than in the surgical group. The incision was the most extended in the surgical group. Regarding major adverse events, no significant differences were found among the three groups. CONCLUSIONS: Transcatheter and intraoperative device closure and surgical repair for ASD are all safe and effective. Considering their respective disadvantages and advantages, the transcatheter approach may be the first choice for an isolated secundum ASD, the intraoperative approach may be the second choice, and surgical repair may be the last resort.
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Qiu et al. (2019) conducted a cohort in Isolated secundum atrial septal defect (n=87). Transcatheter and intraoperative device closure vs. Surgical repair was evaluated on Successful ASD closure at 1 year (lack of residual shunt < 2 mm). Transcatheter and intraoperative device closure for atrial septal defect achieved a 100% successful closure rate at one year, similar to surgical repair, but with significantly shorter operative times and hospital stays.
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