Factors influencing the choice of atrial septal occluder for transcatheter closure of secundum atrial septal defects
10.3760/cma.j.issn.0253-3758.2009.11.008
- VernacularTitle:房间隔缺损介入治疗封堵器选择的影响因素
- Author:
Yu-Shun ZHANG
1
;
Bei-Di LAN
;
Huan LI
;
Xu-Mei HE
;
Zheng-Xue DAI
;
Hai-Chang WANG
;
Jun ZHANG
;
Jun LI
;
Ya-Juan DU
Author Information
1. 西安交通大学医学院附属第一医院
- Keywords:
Heart septal defects;
atrial;
Heart catheterization;
Occluder device
- From:
Chinese Journal of Cardiology
2009;37(11):981-985
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze factors influencing the choice of atrial septal occluder (ASO) for transcatheter closure of patients with secundum atrial septal defect (ASD). Methods A total of 1114 ASD patients [388 males, aged from 2 to 75 years, mean age (26.3±17.0) years] were enrolled. Patients were divided to adult (>14 years, mean 34.4 years, n=779 ) and child (≤14 years, mean 7.3 years, n= 335) groups. ASD size in different ultrasound cross-sections was determined by transthoracic echocardiography (TTE). ASO size was chosen on the basis of the maximum diameter of the defect (MD). Defect-shapes and rim lengths of ASD, the difference choice of ASO in the two groups were compared. Results MD of the defects ranged from 5 to 40 mm [mean (19.7±7.8) mm]. ASD was successfully occluded in 1085 out of 1114 patients (97.4%). Occluder size ranged from 6 to 46 nun[mean (25.8±8.9) mm] and the difference between occluder size and MD ranged from 2 to 10 mm [mean (6.1± 3.4) mm, ASO/MD ratio 1.3:1]. Though the diameter of the defect was similar between the 2 groups, the size of occluder was significantly larger in adult group than that in child group (ASO/MD ratio 1.1-1.6:1 vs. 1.2-1.8:1, P<0.05). MD was significantly correlated with ASO in both groups (r=0.911 and r=0.944 in adults and child groups, respectively, all P<0.01). The size and increment of the occluder used in patients with deficient anterior rims was significantly bigger than patients with sufficient anterior rims (P<0.01). Conclusion The maximum diameter of the defect was the major determinant for selecting oecluder size and choice of occluder size was also influenced by patient age, defect-shape and defect rim for transcatheter closure of secundum ASD.
