What is the clinical evidence from this study?

Study design: Observational. Population: Multi-hole secundum atrial septal defect (MHASD) (n=150). Intervention: Device closure (peratrial or percutaneous). Primary outcome: Complete occlusion rate at 1 year.

July 4, 2019Journal of Cardiothoracic SurgeryOpen Access

Device closure of diverse layout of multi-hole secundum atrial septal defect: different techniques and long-term follow-up

Q: What does this research mean for the field?

Tailored device closure of multi-hole secundum atrial septal defects based on defect layout achieves a 100% procedural success rate, with complete occlusion rates of 70% at discharge and 82% at 1-year follow-up. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Device closure of multi-hole secundum ASDs achieves 82% complete occlusion at one year.

n=150

Why the study?

There are no unanimous reports on different layouts and classifications of multi-hole secundum atrial septal defects and standardized occlusion techniques.

Does device closure using tailored techniques based on defect layout improve occlusion results in patients with multi-hole secundum atrial septal defects?

Study Design

Type

Observational (n=150)

Multicenter

Structured PICO

Does device closure using tailored techniques based on defect layout improve occlusion results in patients with multi-hole secundum atrial septal defects?

Population

150 patients aged 6 months to 64 years with multi-hole secundum atrial septal defects underwent device closure and were followed for a median of 48 months.

Intervention

Device closure using peratrial approach (n=122) or percutaneous approach (n=28) under exclusive transesophageal echocardiographic guidance, tailored to defect type (A, B, C, D)

Comparator

Comparison between peratrial and percutaneous approaches, and between different defect types

Outcome

Successful occlusion, intracardiac manipulation time, procedural time, double device deployment, redeployment rate, residual shunt, and proportions

Tailored device closure techniques based on the diverse layouts of multi-hole secundum atrial septal defects yield high successful occlusion rates.

Limitations

Small number of patients in some subtypes of MHASDs
Limited experience with the inter-defects septal puncture (IDSP) technique (only 8 patients)
Requirement of general anesthesia for the peratrial technique
The proposed classification is not strict enough for definitive technique or device selection

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports tailored closure feasibility for multi-hole secundum ASD; leaves open randomized trials before practice change.

Cite This Study

Farhaj et al. (2019) conducted an observational in Multi-hole secundum atrial septal defect (MHASD) (n=150). Device closure (peratrial or percutaneous) was evaluated on Complete occlusion rate at 1 year. Device closure of diverse multi-hole secundum atrial septal defects achieved a 100% procedural success rate, with complete occlusion rates of 70% at discharge and 82% at 1-year follow-up.

synapsesocial.com/papers/6aaf47be57801c33a0f16daa https://doi.org/10.1186/s13019-019-0952-5

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Device closure of diverse layout of multi-hole secundum atrial septal defect: different techniques and long-term follow-up

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Device closure of diverse layout of multi-hole secundum atrial septal defect: different techniques and long-term follow-up

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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