Open Access

ARTICLE

Strategy of treating secundum atrial septal defect not referred to percutaneous closure

Fei Zhang¹, Yifeng Yang², Qin Wu², Wancun Jin², Haisong Bu², Sijie Wu², Tianli Zhao², Shijun Hu²

1 NanShan people’s hospital of ShenZhen, P.R. China
2 Department of Cardiovascular Surgery, the Second Xiangya Hospital, Central South University, Changsha, P.R. China

* Corresponding Author: Shijun Hu, Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Central Road, Changsha, Hunan 410011, P.R. China. Email:

Congenital Heart Disease 2019, 14(3), 324-330. https://doi.org/10.1111/chd.12753

Abstract

Objective: To evaluate safety and effectiveness of intraoperative device closure for secundum atrial septal defect (ASD) not referred to percutaneous closure.
Design and Patients: From April 2010 to December 2018, 231 secundum ASD children (≤14 years) directly recommended to surgical repair were enrolled in this study. These patients were divided into two groups according to the parents’ choice based on surgeons’ recommendation. Follow-up evaluations were adopted at 2 weeks, 3 months, 6 months, and 12 months after the procedure and yearly thereafter. In Group A, 127 patients underwent an initial attempt at device closure. In Group B, 104 patients underwent a repair procedure under cardiopulmonary bypass.
Results: All patients survived. Group A had lower values of operation time, mechanical ventilation time, cardiac intensive care unit duration and amount of blood transfusion. Nevertheless, postoperative hospitalization time between two groups showed no statistical difference. In group A, 109 (85.83%) patients were successfully occluded, whereas 18 (14.17%) patients were converted to open-heart surgery. No severe complications occurred in the follow-up period.
Conclusion: Intraoperative device closure is safe, effective procedure for selected cases with secundum ASDs which were not referred to percutaneous closure because of more suitable occluder selection, no “unbutton effect” and stitching enhancement.

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Keywords

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