Abstract
BackgroundTranscatheter and intraoperative device closure for atrial septal defect (ASD) are widely applied to reduce the incision size and the potential for injury during cardiopulmonary bypass (CPB) in conventional surgical repair. No studies had been conducted to compare the safety and efficiency of these three treatments.MethodsFrom January 2018 to April 2018, 87 patients with an isolated ASD who had undergone transcatheter device closure (n = 45), intraoperative device closure (n = 22) and surgical repair (n = 20) were retrospectively reviewed and further analyzed to compare these three treatments.ResultsThe successful closure rate was similar in the three groups. There was a significant difference in aortic cross-clamping time, CPB duration and operative time between the surgical group and the device groups. The length of intensive care unit stay, postoperative mechanical ventilation time and length of hospital stay were shorter in the two device groups than in the surgical group. The incision was the most extended in the surgical group. Regarding major adverse events, no significant differences were found among the three groups.ConclusionsTranscatheter and intraoperative device closure and surgical repair for ASD are all safe and effective. Considering their respective disadvantages and advantages, the transcatheter approach may be the first choice for an isolated secundum ASD, the intraoperative approach may be the second choice, and surgical repair may be the last resort.
Highlights
Atrial septal defect (ASD) is a common cardiac malformation and accounts for approximately 8 to 10% of cases of congenital heart disease (CHD) [1]
The surgical approach requires cardiopulmonary bypass (CPB) and an incision, foreign bodies are implanted in the treatments, and the occluder might become dislodged in the device groups
One patient in group A was converted to surgical repair due to occluder dislodgement during the procedure, this patient was excluded from the corresponding follow-up data and was not enrolled as part of the surgical group
Summary
From January 2018 to April 2018, 87 patients with an isolated ASD who had undergone transcatheter device closure (n = 45), intraoperative device closure (n = 22) and surgical repair (n = 20) were retrospectively reviewed and further analyzed to compare these three treatments
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