@Article{chd.12753,
AUTHOR = {Fei Zhang, Yifeng Yang, Qin Wu, Wancun Jin, Haisong Bu, Sijie Wu, Tianli Zhao, Shijun Hu},
TITLE = {Strategy of treating secundum atrial septal defect not referred to percutaneous closure},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {3},
PAGES = {324--330},
URL = {http://www.techscience.com/schd/v14n3/38798},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> To evaluate safety and effectiveness of intraoperative device closure for 
secundum atrial septal defect (ASD) not referred to percutaneous closure.<br/>
<b>Design and Patients:</b> 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.<br/>
<b>Results:</b> 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.<br/>
<b>Conclusion:</b> 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.},
DOI = {10.1111/chd.12753}
}