Feasibility of transcatheter closure for absent aortic rim in patients with atrial septal defect
Feasibility of transcatheter closure for absent aortic rim in patients with atrial septal defect
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房间隔缺损患者主动脉环缺失经导管封堵的可行性
DOI：
10.1002/ccd.29457
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发表时间：
2021
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
目的本研究旨在评估经导管房间隔缺损 (ASD) 封堵术治疗主动脉环缺如的患者的可行性。背景对于主动脉环缺如 ASD 的经导管封堵指征存在争议。方法我们纳入了 547 名计划进行经导管封堵的 ASD 患者。使用经食管超声心动图（TEE）评估主动脉边缘的形态。结果在 396 名（72%）患者中观察到主动脉边缘 <5mm； 128 名 (23%) 的主动脉边缘缺损为 0 毫米，268 名 (49%) 的主动脉边缘缺损大于 0 至 <5 毫米。主动脉边缘缺如的患者在 TEE 上经常出现主动脉边缘缺如 0° 和间隔排列不良的情况。在 128 例主动脉边缘缺如的患者中，126 例（98%）成功接受了经导管封堵术，而 2 例（2%）由于大缺损和严重的间隔排列不良而导致经导管封堵失败。主动脉边缘缺如和主动脉边缘缺损的患者经导管封堵的成功率相似（98% vs. 99%，p= .45）。手术后，在中位随访 24 个月期间，没有患者出现糜烂或装置栓塞。结论 对于主动脉边缘缺如的患者以及主动脉边缘缺损的患者，经导管封堵术成功进行，没有出现不良事件。我们的研究结果对于确定 ASD 患者经导管封堵的指征非常有价值。
ObjectivesThis study aimed to assess the feasibility of transcatheter atrial septal defect (ASD) closure in patients with absent aortic rim.BackgroundThe indication of transcatheter closure for ASD with absent aortic rim is controversial.MethodsWe enrolled 547 patients with ASD who were scheduled for transcatheter closure. Morphologies of aortic rim were evaluated using transesophageal echocardiography (TEE).ResultsAortic rim of <5 mm was observed in 396 (72%) patients; 128 (23%) had absent aortic rim of 0 mm, and 268 (49%) had deficient aortic rim of >0 to <5 mm. Patients with absent aortic rim frequently had aortic rim absence at an angle of 0° on TEE and septal malalignment. Of the 128 patients with absent aortic rim, 126 (98%) successfully underwent transcatheter closure, while 2 (2%) failed transcatheter closure due to a large defect with severe septal malalignment. The success rate of transcatheter closure was similar between patients with absent aortic rim and those with deficient aortic rim (98% vs. 99%,p= .45). After the procedure, no patients had erosion or device embolization during a median follow‐up of 24 months.ConclusionsTranscatheter closure was successfully performed without adverse events in patients with absent aortic rim, as well as in those with deficient aortic rim. Our findings can be valuable to determine the indication of transcatheter closure in patients with ASD.
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