Clinical Outcomes of Atrial Septal Defect Occlusion for Patients with Atrial Septal Defect and Tricuspid Regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIANGLian-yong ,  DINGFang-bao , HUANGJian-bing , BIRui , MEIJu

Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, P. R. China;

Corresponding?author：

DINGFang-bao, Email: drnail1969@sina.com

Keywords：

Tricuspid regurgitation; Atrial septal defect; Transcatheter closure

DOI：

10.7507/1007-4848.20140177

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize clinical outcomes of atrial septal defect (ASD)occlusion for patients with ASD and tricuspid regurgitation (TR). Methods Between July 2006 and January 2012, 98 patients with ASD and TR under-went ASD occlusion in Xinhua Hospital, Shanghai Jiaotong University School of Medicine. There were 36 male and 62 female patients with their age aging from 2 months to 80 years. All ASD were secundum ASD with their diameter of 3-23 mm. There were 60 patients with mild TR, 28 patients with moderate TR, and 10 patients with severe TR. All the patients received ASD closure without specific management for TR, including 51 patients under digital subtraction angiography (DSA), 46 patients via a minithoracotomy approach, and 1 patient guided by transthoracic echocardiography. All the patients were followed up with echocardiography to evaluate changes of TR after ASD closure. Results There was no in-hospital death. ASD occlusion was not successful in 1 patient who was found to have residual ASD shunt on the third postoperative day. Another patient underwent reexploration for abnormal bleeding on the third postoperative day. All the other patients had uneventful postoperative recovery. Eighty-four patients were followed up for 1-64 (26.56±21.35)months. During follow-up, the patient who have residual ASD shunt on the third postoperative day received open chest repair 6 months after discharge. TR of 73 patients (86.90%)improved in different degrees. Preoperative severe TR in 10 patients changed into mild TR in 8 patients, moderate TR in 1 patients and still severe TR in 1 patient. Preoperative moderate TR in 26 patients changed into none TR in 6 patients, mild TR in 18 patients and still moderate TR in 2 patients. Preoperative mild TR in 48 patients changed into none TR in 40 patients and still mild TR in 8 patients. Conclusion For patients with ASD and TR, conservative treatment strategy is recommended. Simple ASD closure can provide satisfactory clinical outcomes, and also avoid adverse complications of cardiopulmonary bypass including myocardial injury and lung injury.

Citation： JIANGLian-yong, DINGFang-bao, HUANGJian-bing, BIRui, MEIJu. Clinical Outcomes of Atrial Septal Defect Occlusion for Patients with Atrial Septal Defect and Tricuspid Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 624-627. doi: 10.7507/1007-4848.20140177 Copy

1.	Galal MO, Wobst A, Halees Z, et al. Peri-operative complications following surgical closure of atrial septal defect type Ⅱ in 232 patients-a baseline study. Eur Heart J, 1994, 15(10):1381-1384.
2.	高偉, 周愛卿, 余志慶, 等.兒童繼發孔型房間隔缺損的介入治療.中華兒科雜志, 2004, 42(4):287-290.
3.	馬周瑞, 楊應南, 李亞雄, 等.中老年繼發孔型房間隔缺損的外科治療.中國胸心血管外科臨床雜志, 2009, 16(3):229-231.
4.	韓林, 郝家驊, 張寶仁, 等. 40歲以上繼發孔型房間隔缺損手術治療經驗.中華胸心血管外科雜志, 2000, 16(1):13-15.
5.	Butera G, Carminati M, Chessa M, et al. Percutaneous versus surg-ical closure of secundum atrial septal defect:comparison of early results and complications. Am Heart J, 2006, 151(1):228-234.
6.	李巔遠, 閆軍, 李守軍, 等.三種不同微創技術與經典外科技術治療房間隔缺損的臨床對比研究.中國胸心血管外科臨床雜志, 2009, 16(1):31-35.
7.	Messent M, Sullivan K, Keogh BF, et al. Adult respiratory distress syndrome following cardiopulmonary bypass:incidence and prediction. Anaesthesia, 1992, 47(3):267-268.
8.	Wan S, Leclerc JL, Vincent JL. Inflammatory response to cardiopu-lmonary bypass:mechanisms involved and possible therapeutic strategies. Chest, 1997, 112(3):676-692.
9.	Tanita T, Song C, Kubo H, et al. Superoxide anion mediates pulmonary vascular permeability caused by neutrophils in cardiopulmonary bypass. Surg Today, 1999, 29(8):755-761.
10.	Gu Yj, Boonstra PW, Graaff R, et al. Pressure drop, shear stress, and activation of leukocytes during cardiopulmonary bypass:a comparison between hollow fiber and flat sheet membrane oxygenators.Artif Organs, 2000, 24(1):43-48.
11.	劉罡, 杜德祿, 李延軍.左旋精氨酸對小兒先天性室間隔缺損手術體外循環中肺的保護作用.中華實用兒科臨床雜志, 2013, 28(11):876-877.
12.	Shah D, Azhar M, Oakley CM, et al. Natural history of secundum atrial septal defect in adults after medical or surgical treatment:a historical prospective study. Br Heart J, 1994, 71(3):224-228.
13.	Konstantinides S, Geibel A, Olschewski M, et al. A comparison of surgical and medical therapy for atrial septal defect in adults. N Engl J Med, 1995, 333(8):469-473.
14.	Campbell M. Natural history of atrial septal defect. Br Heart J, 1970, 32(6):820-826.
15.	Yalonetsky S, Lorber A. Comparative changes of pulmonary artery pressure values and tricuspid valve regurgitation following transcatheter atrial septal defect closure in adults and the elderly. Congenit Heart Dis, 2009, 4(1):17-20.
16.	Wu ET, Akagi T, Taniguchi M, et al. Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults. Catheter Cardiovasc Interv, 2007, 69(6):866-871.
17.	Santoro G, Pascotto M, Sarubbi B, et al. Early electrical and geome-tric changes after percutaneous closure of large atrial septal defect. Am J Cardiol, 2004, 93(7):876-880.
18.	A?a? MT, Akyüz AR, Acar Z, et al. Evaluation of right ventricular function in early period following transcatheter closure of atrial septal defect. Echocardiography, 2012, 29(3):358-362.
19.	Pascotto M, Santoro G, Cerrato F, et al. Time-course of cardiac remodeling following transcatheter closure of atrial septal defect. Int J Cardiol, 2006, 112(3):348-352.
20.	陳寄梅, 莊建, 張鏡方, 等.兒童期心臟瓣膜成形術.中國胸心血管外科臨床雜志, 2004, 11(1):29-31.
21.	柳克曄, 來永強, 羅志強, 等. "緣對緣"瓣膜成形術在先天性心臟病合并重度三尖瓣關閉不全中的應用.中華胸心血管外科雜志, 2010, 26(6):371-373.

1. Galal MO, Wobst A, Halees Z, et al. Peri-operative complications following surgical closure of atrial septal defect type Ⅱ in 232 patients-a baseline study. Eur Heart J, 1994, 15(10):1381-1384.
2. 高偉, 周愛卿, 余志慶, 等.兒童繼發孔型房間隔缺損的介入治療.中華兒科雜志, 2004, 42(4):287-290.
3. 馬周瑞, 楊應南, 李亞雄, 等.中老年繼發孔型房間隔缺損的外科治療.中國胸心血管外科臨床雜志, 2009, 16(3):229-231.
4. 韓林, 郝家驊, 張寶仁, 等. 40歲以上繼發孔型房間隔缺損手術治療經驗.中華胸心血管外科雜志, 2000, 16(1):13-15.
5. Butera G, Carminati M, Chessa M, et al. Percutaneous versus surg-ical closure of secundum atrial septal defect:comparison of early results and complications. Am Heart J, 2006, 151(1):228-234.
6. 李巔遠, 閆軍, 李守軍, 等.三種不同微創技術與經典外科技術治療房間隔缺損的臨床對比研究.中國胸心血管外科臨床雜志, 2009, 16(1):31-35.
7. Messent M, Sullivan K, Keogh BF, et al. Adult respiratory distress syndrome following cardiopulmonary bypass:incidence and prediction. Anaesthesia, 1992, 47(3):267-268.
8. Wan S, Leclerc JL, Vincent JL. Inflammatory response to cardiopu-lmonary bypass:mechanisms involved and possible therapeutic strategies. Chest, 1997, 112(3):676-692.
9. Tanita T, Song C, Kubo H, et al. Superoxide anion mediates pulmonary vascular permeability caused by neutrophils in cardiopulmonary bypass. Surg Today, 1999, 29(8):755-761.
10. Gu Yj, Boonstra PW, Graaff R, et al. Pressure drop, shear stress, and activation of leukocytes during cardiopulmonary bypass:a comparison between hollow fiber and flat sheet membrane oxygenators.Artif Organs, 2000, 24(1):43-48.
11. 劉罡, 杜德祿, 李延軍.左旋精氨酸對小兒先天性室間隔缺損手術體外循環中肺的保護作用.中華實用兒科臨床雜志, 2013, 28(11):876-877.
12. Shah D, Azhar M, Oakley CM, et al. Natural history of secundum atrial septal defect in adults after medical or surgical treatment:a historical prospective study. Br Heart J, 1994, 71(3):224-228.
13. Konstantinides S, Geibel A, Olschewski M, et al. A comparison of surgical and medical therapy for atrial septal defect in adults. N Engl J Med, 1995, 333(8):469-473.
14. Campbell M. Natural history of atrial septal defect. Br Heart J, 1970, 32(6):820-826.
15. Yalonetsky S, Lorber A. Comparative changes of pulmonary artery pressure values and tricuspid valve regurgitation following transcatheter atrial septal defect closure in adults and the elderly. Congenit Heart Dis, 2009, 4(1):17-20.
16. Wu ET, Akagi T, Taniguchi M, et al. Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults. Catheter Cardiovasc Interv, 2007, 69(6):866-871.
17. Santoro G, Pascotto M, Sarubbi B, et al. Early electrical and geome-tric changes after percutaneous closure of large atrial septal defect. Am J Cardiol, 2004, 93(7):876-880.
18. A?a? MT, Akyüz AR, Acar Z, et al. Evaluation of right ventricular function in early period following transcatheter closure of atrial septal defect. Echocardiography, 2012, 29(3):358-362.
19. Pascotto M, Santoro G, Cerrato F, et al. Time-course of cardiac remodeling following transcatheter closure of atrial septal defect. Int J Cardiol, 2006, 112(3):348-352.
20. 陳寄梅, 莊建, 張鏡方, 等.兒童期心臟瓣膜成形術.中國胸心血管外科臨床雜志, 2004, 11(1):29-31.
21. 柳克曄, 來永強, 羅志強, 等. "緣對緣"瓣膜成形術在先天性心臟病合并重度三尖瓣關閉不全中的應用.中華胸心血管外科雜志, 2010, 26(6):371-373.

Previous Article
Comparison of Clinical Therapeutic Efficacy of Four Kinds of Surgical Procedures for Pilonidal Sinus
Next Article
Experience of cylindrical abdominoperineal resection for rectal cancer

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Outcomes of Atrial Septal Defect Occlusion for Patients with Atrial Septal Defect and Tricuspid Regurgitation

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content