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Brazilian Journal of Cardiovascular... Aug 2021Atrial septal aneurysm (ASA) is an uncommon but wellrecognized cardiac abnormality. This educational text reviews the case of a 54-year-old female presenting an ASA...
Atrial septal aneurysm (ASA) is an uncommon but wellrecognized cardiac abnormality. This educational text reviews the case of a 54-year-old female presenting an ASA related to a small ostium secundum atrial septal defect. The considerable signs and symptoms, interestingly, have not been justified by the clinical and hemodynamic investigations. So, we opted for a better imaging investigation with cardiac catheterization and transesophageal echocardiography. The surgical process was earlier indicated and performed with aid of cardiopulmonary bypass.
Topics: Cardiac Catheterization; Echocardiography, Transesophageal; Female; Heart Aneurysm; Heart Septal Defects, Atrial; Hemodynamics; Humans; Middle Aged
PubMed: 34236809
DOI: 10.21470/1678-9741-2020-0464 -
Archives of Cardiovascular Diseases 2018
Topics: Cardiac Catheterization; Echocardiography, Three-Dimensional; Heart Septal Defects, Atrial; Humans; Predictive Value of Tests; Radiography, Interventional; Septal Occluder Device; Treatment Outcome; Ultrasonography, Interventional
PubMed: 29661669
DOI: 10.1016/j.acvd.2018.03.003 -
Internal Medicine (Tokyo, Japan) Jan 2022
Topics: Cardiac Catheterization; Echocardiography, Transesophageal; Heart Septal Defects, Atrial; Humans; Prosthesis Design; Septal Occluder Device; Treatment Outcome
PubMed: 33583908
DOI: 10.2169/internalmedicine.6946-20 -
Journal of Cardiology Jan 2015After the introduction of catheter intervention for atrial septal defect (ASD) in the pediatric population, therapeutic advantages of this less invasive procedure were... (Review)
Review
After the introduction of catheter intervention for atrial septal defect (ASD) in the pediatric population, therapeutic advantages of this less invasive procedure were focused on adult through geriatric populations. The most valuable clinical benefits of this procedure are the significant improvement of symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy and cardiopulmonary bypass surgery. These benefits contribute to increase the number of adult patients of this condition who have hesitated over surgical closure. In terms of technical point of view for catheter closure of ASD, the difficulties still exist in some morphological features of defect, or hemodynamic features in the adult population. Morphological features of difficult ASD closure are (1) large (≥30 mm) ASD, (2) wide rim deficiency, and (3) multiple defects. Hemodynamic features of difficult ASD are (1) severe pulmonary hypertension, (2) ventricular dysfunction, and (3) restrictive left ventricular compliance (diastolic dysfunction) after ASD closure. To complete the catheter ASD closure under these difficult conditions, various procedural techniques have been introduced. These are new imaging modalities such as real-time three-dimensional imaging, new technical modifications, and new concepts for hemodynamic evaluation. Especially, real-time three-dimensional transesophageal echocardiography can provide the high quality imaging for anatomical evaluation including maximum defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management for their comorbidities is an important issue, which includes cardiac function, atrial arrhythmias, respiratory function, and renal function. Management of atrial arrhythmias is a key issue for the long-term outcome in adult patients. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back-up system is essential for the safe achievement of the procedure. Finally, the establishment of a team approach including pediatric and adult cardiologists, cardiac surgeons, and anesthesiologists is the most important factor for a good therapeutic outcome.
Topics: Adult; Aged; Cardiac Catheterization; Cardiac Surgical Procedures; Echocardiography, Transesophageal; Heart Septal Defects, Atrial; Hemodynamics; Humans; Middle Aged; Surgery, Computer-Assisted
PubMed: 25308548
DOI: 10.1016/j.jjcc.2014.09.002 -
Multimedia Manual of Cardiothoracic... 2014Atrial septal defect (ASD) is one of the most common congenital cardiac diseases. This pathology can be treated with percutaneous devices. However, some of the ASDs are...
Atrial septal defect (ASD) is one of the most common congenital cardiac diseases. This pathology can be treated with percutaneous devices. However, some of the ASDs are not suitable for device closure. Also, there may be device-related late complications of transcatheter ASD closure. Currently, robotic surgical techniques allow surgeons to close ASDs in a totally endoscopic fashion with a high success rate and a low complication rate. This study demonstrates the basic concepts and technique of robotic ASD closure.
Topics: Adult; Cardiac Surgical Procedures; Echocardiography; Endoscopy; Female; Heart Septal Defects, Atrial; Humans; Intraoperative Care; Male; Middle Aged; Minimally Invasive Surgical Procedures; Postoperative Complications; Prosthesis Implantation; Robotic Surgical Procedures; Septal Occluder Device; Treatment Outcome
PubMed: 25107453
DOI: 10.1093/mmcts/mmu014 -
BMJ Case Reports May 2014Dilated cardiomyopathy, heart failure and atrial septal defects are well-recognised entities in isolation, but are rarely seen together. Now that 90% of children with... (Review)
Review
Dilated cardiomyopathy, heart failure and atrial septal defects are well-recognised entities in isolation, but are rarely seen together. Now that 90% of children with congenital heart disease survive into adulthood, such combinations of disease are increasingly seen in adult cardiology. While most young patients with dilated cardiomyopathy respond well to medical therapy, some do not, and require more invasive management. We describe a 32 year-old man with dilated cardiomyopathy and a sinus venosus-type atrial septal defect associated with a remarkable pulmonary to systemic flow ratio of 5:1. We propose that the atrial septal defect blunted his heart failure symptoms by serving as a 'pop-off' valve and limiting pulmonary congestion. The patient ultimately failed medical management and received a left ventricular assist device. The case is presented along with a discussion of this unique pathophysiology and a brief review of the literature in this rapidly evolving field.
Topics: Adrenergic beta-Antagonists; Adult; Angiotensin-Converting Enzyme Inhibitors; Cardiomyopathy, Dilated; Defibrillators, Implantable; Diagnosis, Differential; Electrocardiography; Follow-Up Studies; Heart Septal Defects, Atrial; Humans; Magnetic Resonance Imaging, Cine; Male; Radiography, Thoracic; Severity of Illness Index; Tomography, X-Ray Computed
PubMed: 24855073
DOI: 10.1136/bcr-2013-201306 -
JACC. Cardiovascular Interventions Jan 2021
Topics: Heart Septal Defects, Atrial; Humans; Iatrogenic Disease; Mitral Valve; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 33413866
DOI: 10.1016/j.jcin.2020.12.004 -
Scientific Reports Jun 2021Percutaneous mitral valve repair (PMVR) requires transseptal puncture and results in iatrogenic atrial septal defect (iASD). The impact of persistent iASD was previously...
Percutaneous mitral valve repair (PMVR) requires transseptal puncture and results in iatrogenic atrial septal defect (iASD). The impact of persistent iASD was previously investigated. However, data were diverse and inconclusive. 53 patients who underwent MITRACLIP were retrospectively included. Based on the presence of iASD in transesophageal echocardiography (TEE) after 6 months, patients were divided in two groups (iASD group vs. non-iASD group). Impact of iASD on outcome at 6 months and at two years was evaluated. Persistent iASD was detected in 62% of patients. Independent predictors for persistent iASD were female gender and reduced left ventricular ejection fraction. At 6-month follow-up, there was no difference in reduction of NYHA class (ΔNYHA = 1.3 ± 1 in iASD group vs. 0.9 ± 1 in non-iASD group, p = 0.171). There was a significant difference in right ventricular end diastolic diameter (RVEDd) (42 ± 8 mm in iASD-group vs. 39 ± 4 mm in non-iASD group, p = 0.047). However, right ventricular systolic function (TAPSE) (14 ± 7 mm in iASD group vs. 16 ± 8 mm in non-iASD group, p = 0.176) and right ventricular systolic pressure (RVSP) (40 ± 12 mmHg in iASD group vs. 35 ± 10 mmHg in non-iASD group, p = 0.136) were still comparable between both groups. At 2 years follow-up, there was no significant difference regarding rate of rehospitalization (24% vs 15%, p = 0.425) or mortality (12% vs 10%, p = 0.941) between both groups. Incidence of persistent iASD after MITRACLIP is markedly high. Despite the increase in right ventricular diameter in patients with persistent iASD, these patients were not clinically compromised compared to patients without persistent iASD.
Topics: Aged; Cardiac Surgical Procedures; Echocardiography, Transesophageal; Female; Heart Septal Defects, Atrial; Humans; Iatrogenic Disease; Incidence; Male; Mitral Valve; Mitral Valve Insufficiency; Postoperative Complications; Treatment Outcome
PubMed: 34135437
DOI: 10.1038/s41598-021-92255-3 -
Annals of Cardiac Anaesthesia 2019Atrial septal defect (ASD) is a common congenital heart disease associated with volume overload of Right ventricle (RV) with variable effect on Left ventricle (LV)....
BACKGROUND
Atrial septal defect (ASD) is a common congenital heart disease associated with volume overload of Right ventricle (RV) with variable effect on Left ventricle (LV). Two-dimensional (2D) Strain analysis is a new tool for objective analysis of myocardial function. This prospective study evaluated the systolic function of right and left ventricle by conventional 2D echo and strain echo and measured changes in cardiac hemodynamics that occurred in patients of ASD before and after correction.
PATIENTS AND METHODS
2D echo and strain analysis of each patient before and at 48 hrs, 3 months and 6 months after correction was performed. Routine 2D echo parameters and global longitudinal strain of both ventricles were measured.
RESULT
Improvement in LV ejection fraction (P = 0.0001) and myocardial performance index (MPI) (P < 0.0001) occurred at the end of 6 months, whereas decrease in RV MPI (P < 0.0001) and tricuspid annular plane systolic excursion (P < 0.0001) became statistically significant after 3 months of ASD correction. In comparison to conventional 2D echo, global longitudinal strain of RV decreased significantly only after 48 hours of ASD correction while there was no improvement in left ventricular global longitudinal strain after 6 month of correction.
CONCLUSION
There was improvement in RV function with subtle change in LV function by strain imaging and most of these changes were completed within 6 months of ASD correction and nearly correlated with conventional 2DEchocardiography.
Topics: Adolescent; Child; Child, Preschool; Female; Heart Septal Defects, Atrial; Humans; Infant; Infant, Newborn; Male; Prospective Studies; Ventricular Function, Left; Ventricular Function, Right
PubMed: 30648678
DOI: 10.4103/aca.ACA_153_17 -
Acta Medica Indonesiana Oct 2022Atrial septal defect developed pulmonary hypertension (ASD-PH) at first diagnosis due to late presentation are common in Indonesia. Transthoracic echocardiogram (TTE) is...
Usefulness of Combining NT-proBNP Level and Right Atrial Diameter for Simple and Early Noninvasive Detection of Pulmonary Hypertension Among Adult Patients with Atrial Septal Defect.
BACKGROUND
Atrial septal defect developed pulmonary hypertension (ASD-PH) at first diagnosis due to late presentation are common in Indonesia. Transthoracic echocardiogram (TTE) is a common tool to detect ASD-PH, before proceeding to invasive procedure. The NT-proBNP measurement to screen ASD-PH is not yet considered the standard approach, especially in limited resource conditions. The objective of this study is to assess the value of NT-proBNP, along with simple TTE parameter, to screen PH among adults with ASD.
METHODS
This was a cross-sectional study. The subjects were adult ASD-PH patients from the COHARD-PH registry (n=357). Right heart catheterization (RHC) was performed to diagnose PH. Blood sample was withdrawn during RHC for NT-proBNP measurement. The TTE was performed as standard procedure and its regular parameters were assessed, along with NT-proBNP, to detect PH.
RESULTS
Two parameters significantly predicted PH, namely NT-proBNP and right atrial (RA) diameter. The cut-off of NT-proBNP to detect PH was ≥140 pg/mL. The cut-off of RA diameter to detect PH was ≥46.0 mm. The combined values of NT-proBNP level ≥140 pg/mL and RA diameter ≥46.0 mm yielded 46.6% sensitivity, 91.8% specificity, 54.3% accuracy, 96.5% positive predictive value and 26.2% negative predictive value to detect PH, which were better than single value.
CONCLUSION
NT-proBNP level ≥140 pg/mL represented PH in adult ASD patients. The NT-proBNP level ≥140 pg/mL and RA diameter ≥46.0 mm had a pre-test probability measures to triage patients needing more invasive procedure and also to determine when and if to start the PH-specific treatment.
Topics: Humans; Adult; Hypertension, Pulmonary; Atrial Fibrillation; Cross-Sectional Studies; Natriuretic Peptide, Brain; Peptide Fragments; Heart Septal Defects, Atrial; Biomarkers
PubMed: 36624713
DOI: No ID Found