@Article{CHD.2020.011249,
AUTHOR = {Amira Nour, Heba Kamel, Yasmeen Abdelrazik, Khaled Shams, Noha Gamal, Safaa Huessin, Alaa Roushdy, Maiy El Sayed},
TITLE = {Safety and Efficacy of Transcatheter Closure of Atrial Septal Defects in  Everyday Practice. A Multicenter Study in a Developing Country},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {2},
PAGES = {79--87},
URL = {http://www.techscience.com/schd/v15n2/39428},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Transcatheter closure of secudum atrial septal defect (ASD) 
has gained wide acceptance since its introduction more than 3 decades ago. Safety 
and efficacy of the procedure in everyday practice needs continuous update. 
<b>Objective:</b> The aim of the study is to determine the incidence of complications and 
identify everyday management protocols. <b>Methods:</b> This is a prospective 
nonrandomized study including all the patients with Secundum ASD or fenestrated 
IAS referred to two different congenital heart diseases centers in Ain Shams 
university and sohag university in Egypt over 2 years with an indication for closure 
according to American and European guidelines. A custom-made sheet was made to 
include all relevant demographic and procedural data as well as any intra or 
periprocedural complications. <b>Results:</b> This study evaluated 330 patients over a 
period of 2 years. Most of the patients were in pediatric age group where the mean 
age was 12 +/– 13 years, mean weight of 40 +/– 15 kg, the mean device diameter used 
was 20 +/– 7.7 mm. The procedure was successful in 326, four patients required 2 
simultaneous devices, and another three adult patients underwent simultaneous 
percutaneous coronary intervention (PCI). There were 26/330 (7.7%) complications, 
only one was life threating complication (0.3%); a LA appendage perforation which 
was managed surgically. The remaining complications were either major or minor, 
the most common was arrhythmia in 7 patients (2.3%), followed by device 
embolization in 5 patients (1.5%) all of them were retrieved percutaneously except 
one which was removed surgically. Four patients (1.2%) developed thrombus either 
on the right atrial side or LA side or both, managed successfully by anti-coagulation, 
similarly another four patients (1.2%) had pericardial effusion +/– hemopericardium, 
one of which was due to erosion of the left atrial roof while none of our patients had 
residual shunts. Two patients had anesthesia related complications, one patient 
developed nickel allergy and one patient had vascular complication. <b>Conclusion:</b> Although transcatheter ASD closure is a safe and effective procedure, but a wide range of complications should be anticipated and managed properly. In high volume 
centers with proper patient selection, complications could be significantly reduced 
but not completely abolished.},
DOI = {10.32604/CHD.2020.011249}
}