Effect Of Percutaneous Closure Research Articles

Effect of percutaneous closure on atrium and appendage functions in patients with secundum atrial septal defects.

The study aimed to assess the impact of percutaneous transcatheter atrial septal defect (ASD) closure on atrium and atrial appandage functions among patients with ostium secundum ASDs. A total of 101 patients (34,7% male, 65,3% female, 37,6 ± 12) with the diagnosis of ostium secundum type ASD underwent transthorasic (TTE) and transesophageal echocardiography (TEE) before and six months after percutaneous transcatheter ASD closure. Pulmonary venous flow and atrial appendage flow velocities were obtained from the TEE recordings. The offline evaluation of the global and segmental atrial appendage strains were evaluated with speckle tracking echocardiography (STE) via EchoPac 6,3 (GE Vingmed, Horten, Norway). Mean values of pulmonary artery pressure, right ventricular, left atrium, left ventricular end-diastolic and end-systolic diameters were significantly decreased 6 months after ASD closure. Statistically significant changes were documented in pulmonary venous and left atrial appendage flow velocities after ASD closure. Both left and right atrial appendage flow velocities and global strains of atrial appandages were improved after ASD closure. The mean left atrial appendage global strain value was - 11.45 ± 4.13% before the procedure, this value was - 16.82 ± 3.78% sixth months after the procedure (P < 0.001).The mean right atrial appendage global strain was - 13.31 ± 4.84% before the procedure and - 18.53 ± 4.69% sixth months after the procedure (P < 0.001). Left and right atrial appendage flow velocities and global strains of left and right atrial appandage can be improved after transcatheter ASD closure. Percutaneous transcatheter closure of ASDs not only improves atrial and left ventricular dimensions but also have a positive impact on left and right atrial appandage functions.

Percutaneous secundum atrial septal defect closure for the treatment of atrial arrhythmia in the adult: A meta-analysis

BackgroundAtrial arrhythmias are common in patients with atrial septal defects (ASD) but the effects of percutaneous closure on atrial arrhythmia prevalence is unclear. We investigated the effects of ASD device closure and the impact of age at time of closure on prevalent atrial arrythmia. MethodsMeta-analysis of studies reporting atrial arrhythmia prevalence in adult patients before and after percutaneous closure was performed. Primary outcomes were prevalence of ‘all atrial arrhythmia’ and atrial fibrillation alone post closure. Sub-group analysis examined the effects of closure according to age in patients; <40 years, ≥40 and ≥ 60 years. 25 studies were included. ResultsMeta-analysis of all studies demonstrated no reduction in all atrial arrhythmia or atrial fibrillation prevalence post-closure (OR 0.855, 95% CI 0.672 to 1.087, P = .201 and OR 0.818, 95% CI 0.645 to 1.038, P = .099, respectively). A weak reduction in all atrial arrhythmia and atrial fibrillation was seen in patients ≥40 years (OR 0.77, 95% CI 0.616 to 0.979, P = .032 and OR 0.760, 95% CI 0.6 to 0.964, P = .024, respectively) but not ≥60 years (OR 0.822, 95% CI 0.593 to 1.141, P = .242 and OR 0.83, 95% CI 0.598 to 1.152, P = .266, respectively). No data were available in patients <40 years. This, and other limitations, prevents conclusive assessment of the effect of age on arrhythmia prevalence. ConclusionsOverall, percutaneous ASD closure is not associated with a reduction in atrial arrhythmia prevalence in this meta-analysis. A weak benefit is seen in patients ≥40 years of age, not present in patients ≥60 years.

OP-101 [AJC » PI for SHD - ASD, VSD, PDA closure] The Effect of Percutaneous Closure of Atrial Septal Defects on the PR Interval

OP-101 [AJC » PI for SHD - ASD, VSD, PDA closure] The Effect of Percutaneous Closure of Atrial Septal Defects on the PR Interval

Speckle-Tracking Echocardiography in Dogs With Patent Ductus Arteriosus: Effect of Percutaneous Closure on Cardiac Mechanics.

BackgroundPatent ductus arteriosus (PDA) is 1 of the most common congenital heart defects in dogs and percutaneous closure is effective in achieving ductal closure; PDA closure is associated with abrupt hemodynamic changes.HypothesisA marked decrease in standard parameters of systolic function as assessed by M‐ or B‐mode echocardiography after PDA closure was identified in previous studies. Speckle tracking echocardiography can provide further insight into the effect of PDA closure on cardiac mechanics in dogs affected by PDA.AnimalsTwenty‐five client‐owned dogs with PDA.MethodsProspective study. Dogs were recruited over a 2‐year period. Complete echocardiographic evaluation was performed before and 24 hours after PDA closure, including standard (end‐diastolic volumes indexed to body surface area in B‐ and M‐mode [EDVIB /M], end‐systolic volumes indexed to body surface area in B‐ and M‐mode [ESVIB /M], allometric scaling in diastole [AlloD] and systole [AlloS], pulmonary flow to systemic flow [Qs/Qp], ejection fraction [EF], and fractional shortening [FS]), and advanced speckle‐tracking echocardiography (STE): global longitudinal, radial, circumferential and transverse strain (S), and strain rate (SR).ResultsPatent ductus arteriosus closure was associated with statistically significant decreases in EDVIM /B and ESVIM /B, AlloD and AlloS, SI, EF, and FS. A statistically significant decrease in the absolute values of radial, transverse, and circumferential S and SR was observed, whereas longitudinal S and SR did not change significantly.Conclusion and Clinical ImportancePatent ductus arteriosus closure by percutaneous approach is associated with marked decreases of conventional echocardiographic parameters as a result of the changes in loading conditions, but no evidence of systolic dysfunction was identified by means of STE, as none of the S and SR values were below reference ranges. In the short term, contractility is enhanced in the long axis (long S/SR values were not statistically different before and after closure) and decreases to normal values in short axis (circumferential, radial, and transversal S/SR decreased to normal reference range).

PP-145 The Effect of Percutaneous Closure of Atrial Septal Defects on the P Wave Dispersion

PP-145 The Effect of Percutaneous Closure of Atrial Septal Defects on the P Wave Dispersion

Transcatheter Closure of Atrial Septal Defect and the Effects on Right Ventricular Function; Strain and Strain Rate Echocardiography

PP-228 In this study, we investigated the effect of percutaneous closure of ASD on the right ventricular global and segmental strain (S)strain rate (SR) values. Our study consisted of 22 patients with secundum ASD and 22 healthy subjects of similar age distribution and characteristics as control

Percutaneous Suture-mediated Closure Versus Surgical Arteriotomy in Endovascular Aortic Aneurysm Repair

Purpose To compare percutaneous suture-mediated closure (PSMC) with surgical closure in endovascular aortic aneurysm repair and examine the influence of obesity, sheath size, and vessel calcification on the effectiveness of percutaneous closure. Materials and Methods A total of 445 patients (mean age, 75.9 ± 7.6 years) undergoing aortic aneurysm repair from 2003 to 2010 were retrospectively reviewed. A total of 100 PSMC and 557 surgical closures for arteriotomies with sheath sizes between 12 F and 18 F were compared in terms of failure, complications, and operating room time. Additionally, effects of arterial calcification, body mass index, and sheath size on PSMC were evaluated. Results Eighty-five percent of PSMCs were successful. Failure was attributed to lack of hemostasis in 11 and difficulty in device positioning in four cases. Complication rate after successful PSMC (9.4%) was significantly less than surgery (19.4%) ( P = .02).When failed PSMC cases were considered as complication, the complication rate was not different between the two groups ( P = .4). Seroma occurred more after surgical closures (11.4% vs1.2%; P = .001). Pseudoaneurysm occurred more after PSMC (3.5% vs 0.18%; P = .008).Average PSMC procedure time was less than that of surgical closure ( P = .0001). PSMC success rate was 89.7% for < 16-F sheaths and 80.4% for ≥ 16-F sheaths ( P = .15). PSMC success was not different between obese and nonobese patients ( P = .22). PSMC success in calcified and noncalcified arteries was not different ( P = .37). Conclusions PSMC is an effective arterial closure method. It is faster and associated with less postprocedure morbidity than surgery. Appropriate technique and meticulous vascular exposure affect PSMC success. Obesity, vascular calcification, and sheath size did not change PSMC outcome in this study.