Morphological assessments of deficient posterior-inferior rim for transcatheter closure of atrial septal defect
Morphological assessments of deficient posterior-inferior rim for transcatheter closure of atrial septal defect
复制标题
经导管封堵房间隔缺损后下缘缺陷的形态学评估
DOI：
10.1002/ccd.29182
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Ito H
中科院分区：
文献类型：
--
作者：
Takaya Y;Akagi T;Nakagawa K;Nakayama R;Miki T;Toh N;Ito H
ObjectivesThis study aims to determine formal characteristics of deficiency posterior-inferior rim for transcatheter atrial septal defect（ASD）closure successful.BackgroundThe possibility of transcatheter closure of ASD with deficient posterior-inferior rim remains unclear.Methodsof 869 patients with ASD who are scheduled transcatheter closure，121 posterior-inferior rim <5 mm was included.后下缘形态进行了评价transesophageal echocardiography. Results 106例患者成功地进行了经导管封堵，而15例患者失败。这15例患者的后下缘完全缺损0 mm和/或大缺损≥38 mm。多变量逻辑回归分析显示，经导管封堵失败与后下缘完全缺损和≥38 mm的大缺损独立相关。在84例患者中观察到>0至<5 mm的不完全缺损后下缘。所有这些患者均成功接受了经导管封堵术，但两名患者存在≥38 mm的大缺损。在37例患者中观察到后下缘完全缺损。经导管封堵失败的患者中，后下缘完全缺损的发生率较高（87% vs. 23%，p <0.01），但如果完全缺损的范围≤30°，则经导管封堵成功。手术后，没有不良事件发生在中位数随访24 months.ConclusionsMost缺乏后下缘的患者成功地进行了经导管封堵。如果范围是部分的，即使是后下缘完全缺损的患者也可以进行经导管封堵。我们的研究结果可以帮助确定经导管封堵的候选人。
ObjectivesThis study aimed to determine morphological characteristics of deficient posterior‐inferior rim for transcatheter atrial septal defect (ASD) closure success.BackgroundThe feasibility of transcatheter closure of ASD with deficient posterior‐inferior rim remains unclear.MethodsOf 869 patients with ASD who were scheduled transcatheter closure, 121 with posterior‐inferior rim of <5 mm were included. Posterior‐inferior rim morphologies were evaluated by transesophageal echocardiography.ResultsOne hundred six patients successfully underwent transcatheter closure, while 15 patients failed. These 15 patients had complete deficient posterior‐inferior rim of 0 mm and/or a large defect of ≥38 mm. Multivariate logistic regression analysis showed that transcatheter closure failure was independently related to complete deficient posterior‐inferior rim and a large defect of ≥38 mm. Incomplete deficient posterior‐inferior rim of >0 to <5 mm was observed in 84 patients. All these patients successfully underwent transcatheter closure, except two patients with a large defect of ≥38 mm. Complete deficient posterior‐inferior rim was observed in 37 patients. The frequency of complete deficient posterior‐inferior rim was higher in patients who failed transcatheter closure (87% vs. 23%,p< .01), but transcatheter closure was performed successfully if the range of complete deficient rim was ≤30°. After the procedure, no adverse events occurred during a median follow‐up of 24 months.ConclusionsMost patients with deficient posterior‐inferior rim successfully underwent transcatheter closure. Transcatheter closure could be performed even in patients with complete deficient posterior‐inferior rim if the range was partial. Our findings can help to identify candidates for transcatheter closure.