Objectives To investigate the causes, theraputic and preventive methods of com- plications associated with transcatheter occlusion of at- rial septal defect ( ASD) using the Amplatzer septal oc- cluder (ASO) in childr...Objectives To investigate the causes, theraputic and preventive methods of com- plications associated with transcatheter occlusion of at- rial septal defect ( ASD) using the Amplatzer septal oc- cluder (ASO) in children. Methods 289 cases un- derwent transcatheter closure of ASD with ASO. Com- plications occurred in 9 cases. The complications in procedure included systemic circulatory systemic air embolism in 2, pulmonary air embolism in 1, pericar- dial tamponade in 1, ASO malposition requiring emer- gency surgical removal in 1, transient atrial extrasysto- les in 1 and sizing balloon rupture in 1 case. 2 cases with postoperative complications were found in the fol- low-up studies. These included perforation of mitral valve and ASO partially dislodged. In this study, 5 children with intraoperative complication received e- mergency therapy including surgical intervention, and others needed only follow-up, as the complications were transient or asymptomatic. Results There were no children death in this study. The 5 cases who re- ceived treatment were completely healing, and the oth- ers with intra - procedure complications were also had no sequela existed. Cases with mitral valve and ASO partially dislodged were still in follow-up studies, as the 2 patients having no symptoms. Conclutions Air embolism were occurred easily in atrial septal defect cases who received ASO therapy. Complications mainly caused by inappropriate operative procedure and some complications needed emergency treatments. Follow-up studies were important to cases with transcatheter oc- clusion therapy.展开更多
Background Transcatheter closure and surgical closure of secundum atrial septal defects(SASDs)are common treatment methods.It is not clear which method has a more obvious technical advantage.Objective To summarise dat...Background Transcatheter closure and surgical closure of secundum atrial septal defects(SASDs)are common treatment methods.It is not clear which method has a more obvious technical advantage.Objective To summarise data from studies comparing transcatheter closure versus surgical closure of SASDs.Methods Databases including Pub Med,EMbase,Web of science,Cochrane Library,CBM,CNKI and Wanfang databases were searched to enroll randomized controlled trials and cohort study trials comparing the two treatment methods(transcatheter closure versus surgical closure).The literature was screened according to the inclusive and exclusive criteria by two reviewers independently.The quality of the trials was evaluated.The data were extracted and meta-analysis was performed using Rev Man 5.3 software.Results 29 original studies(14,941 patients)were included.All studies were non-random.Transcatheter closure was found to be superior to surgical closure in the following outcomes:all-cause mortality(OR 0.36,95%CI 0.21~0.59,P<0.0001),total complications(OR 0.37,95%CI 0.25~0.55,P<0.00001),and hospital stay length(WMD-3.77,95%CI-4.36~-3.18,P<0.00001).Residual shunts incidence and retreatment incidence were more common in the transcatheter closure group than those in the surgical closure group[(OR 3.55,95%CI 1.79~7.05,P=0.0003)and(OR 2.19,95%CI 1.31~3.65,P=0.003),respectively].Conclusions Both approaches are effective for closure SASDs.Transcatheter is associated with lower mortality,complications and hospital stay length,while surgical closure has incidence of residual shunting and retreatment.展开更多
文摘Objectives To investigate the causes, theraputic and preventive methods of com- plications associated with transcatheter occlusion of at- rial septal defect ( ASD) using the Amplatzer septal oc- cluder (ASO) in children. Methods 289 cases un- derwent transcatheter closure of ASD with ASO. Com- plications occurred in 9 cases. The complications in procedure included systemic circulatory systemic air embolism in 2, pulmonary air embolism in 1, pericar- dial tamponade in 1, ASO malposition requiring emer- gency surgical removal in 1, transient atrial extrasysto- les in 1 and sizing balloon rupture in 1 case. 2 cases with postoperative complications were found in the fol- low-up studies. These included perforation of mitral valve and ASO partially dislodged. In this study, 5 children with intraoperative complication received e- mergency therapy including surgical intervention, and others needed only follow-up, as the complications were transient or asymptomatic. Results There were no children death in this study. The 5 cases who re- ceived treatment were completely healing, and the oth- ers with intra - procedure complications were also had no sequela existed. Cases with mitral valve and ASO partially dislodged were still in follow-up studies, as the 2 patients having no symptoms. Conclutions Air embolism were occurred easily in atrial septal defect cases who received ASO therapy. Complications mainly caused by inappropriate operative procedure and some complications needed emergency treatments. Follow-up studies were important to cases with transcatheter oc- clusion therapy.
基金supported by Hainan provincial health industry scientific research project (No.22A200277)。
文摘Background Transcatheter closure and surgical closure of secundum atrial septal defects(SASDs)are common treatment methods.It is not clear which method has a more obvious technical advantage.Objective To summarise data from studies comparing transcatheter closure versus surgical closure of SASDs.Methods Databases including Pub Med,EMbase,Web of science,Cochrane Library,CBM,CNKI and Wanfang databases were searched to enroll randomized controlled trials and cohort study trials comparing the two treatment methods(transcatheter closure versus surgical closure).The literature was screened according to the inclusive and exclusive criteria by two reviewers independently.The quality of the trials was evaluated.The data were extracted and meta-analysis was performed using Rev Man 5.3 software.Results 29 original studies(14,941 patients)were included.All studies were non-random.Transcatheter closure was found to be superior to surgical closure in the following outcomes:all-cause mortality(OR 0.36,95%CI 0.21~0.59,P<0.0001),total complications(OR 0.37,95%CI 0.25~0.55,P<0.00001),and hospital stay length(WMD-3.77,95%CI-4.36~-3.18,P<0.00001).Residual shunts incidence and retreatment incidence were more common in the transcatheter closure group than those in the surgical closure group[(OR 3.55,95%CI 1.79~7.05,P=0.0003)and(OR 2.19,95%CI 1.31~3.65,P=0.003),respectively].Conclusions Both approaches are effective for closure SASDs.Transcatheter is associated with lower mortality,complications and hospital stay length,while surgical closure has incidence of residual shunting and retreatment.
