Clinical observation of iatrogenic atrial septal defect after atrial septal puncture during atrial fibrillation intervention surgery
10.3760/cma.j.cn431274-20230324-00398
- VernacularTitle:房颤介入手术中房间隔穿刺后医源性房间隔缺损的临床观察
- Author:
Suwen ZHU
1
;
Xiaobo LI
;
Shuiyuan LIU
;
Fengfu ZHANG
;
Ling ZHOU
;
Zuoying HU
Author Information
1. 南京医科大学附属南京医院心内科，南京 210006
- Keywords:
Heart septal defects, atrial;
Iatrogenic injury;
Left atrial appendage occlusion;
Cryoballon ablation
- From:
Journal of Chinese Physician
2023;25(12):1811-1814
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the occurrence and closure of iatrogenic atrial septal defect (IASD) after left atrial appendage occlusion (LAAo) and atrial fibrillation cryoballoon ablation (CBA), and to identify potential factors that may affect the occurrence of IASD.Methods:A total of 383 patients who underwent successful LAAo surgery in the Department of Cardiology at the Nanjing Hospital Affiliated to Nanjing Medical University from June 7, 2016 to December 2, 2020, and atrial fibrillation CBA surgery from December 29, 2016 to September 10, 2020 were retrospectively selected. Patients were followed up with echocardiography at 1 month, 3 months, 6 months, 1 year, and>1 year after surgery to determine the occurrence of IASD. The incidence of IASD between the two groups was compared, and clinical data between the two groups with and without IASD were analyzed to identify the relevant factors for the occurrence of IASD.Results:One month after CBA surgery for atrial fibrillation [73.8%(138/187) vs 47.9%(67/140), P<0.001], 3 months [39.0%(57/146) vs 13.6%(16/118), P<0.001], 6 months [17.7%(22/124) vs 3.6%(4/110), P=0.001], 1 year [11.8%(15/127) vs 1.8%(2/112), P=0.003], and one year later [9.8%(13/133) vs 0.9%(1/116), P=0.002], the incidence of IASD was significantly higher than those in LAAo. Compared with the non IASD group, the IASD group had a lower proportion of males [59.0%(121/205) vs 83.6%(102/122), P<0.001], and a higher proportion of paroxysmal atrial fibrillation [61.5%(126/205) vs 45.9%(56/122), P=0.006]. Logistic regression analysis found a significant correlation between women and CBA with postoperative IASD. Conclusions:Compared with LAAo, the incidence of IASD after CBA for atrial fibrillation is higher, and some IASD persist for more than 1 year after surgery. Women are significantly associated with IASD.
