@Article{CHD.2020.011575,
AUTHOR = {Alejandro E. Contreras, Alejandro R. Peirone, Eduardo Cuestas},
TITLE = {Cardiac Troponin Levels after Percutaneous Atrial Septal Defect Closure: A  Qualitative Systematic Review and Meta-Analysis},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {1},
PAGES = {13--20},
URL = {http://www.techscience.com/schd/v15n1/39374},
ISSN = {3071-1738},
ABSTRACT = {<b>Introduction:</b> We conducted a systematic review and meta-analysis of 
published studies to determine the prevalence of troponin elevation after 
percutaneous atrial septal defect closure (pASDc) as well as to describe the 
association between troponin elevation and different anatomical risk factors for 
erosion. <b>Methods:</b> A qualitative systematic review and meta-analysis was 
undertaken. The selected studies included patients of any age receiving a pASDc; 
performed under transesophageal echocardiography monitoring; reporting
troponin level measurement after the intervention; and indicating prevalence of 
troponin elevation and/or the association with risk factors for erosion. <b>Results:</b> Six 
studies were found which included 391 patients in total. The age of the patients 
ranged from 1 to 80 years and were mainly female (between 59 and 81%). The 
success rate of pASDc varied from 92–100%. The prevalence of myocardial injury 
varied between 16% and 100%. In the meta-analysis cohort including 347 patients 
with available data, the fixed effect model showed a prevalence of 41.8% CI (95%) 
36.6% to 47.2%. Five studies found a relationship between the size of the 
implanted device and the presence of myocardial injury. The size of the defect,
multiple defects within the interatrial septum, deficient posterior rim, lack of use 
of sizing balloon and longest duration of the procedure were also related to 
myocardial injury. <b>Conclusion:</b> The usefulness of troponin levels measurements 
after pASDc has been insufficiently studied. The routinely use in a standardized 
protocol would be useful to determine which patients need a closer follow-up.},
DOI = {10.32604/CHD.2020.011575}
}