Fluoroscopy-free Transcatheter Atrial Septal Defect Closure: A Simplified Approach.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2025-02-19 DOI:10.1007/s11886-024-02177-5

Naychi Lwin, Piia Suursalmi, Sophia Yong, Saleha Kabir, Matthew I Jones, Alexandra Savis, Shakeel A Qureshi, Eric Rosenthal

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引用次数: 0

Abstract

Purpose of review: To provide an overview of fluoroscopy-free transcatheter atrial septal defect (ASD) closure and introduce a simplified approach that avoids pulmonary vein instrumentation.

Recent findings: Since the first reported fluoroscopy-free ASD closure 24 years ago, only a few small series have described this technique. We present a simplified and less cumbersome approach to encourage wider adoption of the fluoroscopy-free method to suitable ASD anatomy.

Results: Fluoroscopy free ASD closure was performed in 9 patients using the conventional technique (Group 1) and 23 patients using our simplified approach of direct placement of the device into the defect (Group 2). Median age and weight were 28 years, 53 kg in Group 1 (range: 5-52 years, 22-88 kg) and 36 years, 66 kg in Group 2 (range: 4-76 years, 16-115 kg). Devices were successfully implanted in all patients, with a median device size of 21 mm (Group 1: 9-36 mm, Group 2: 10-33 mm). Procedural time was 47 min for Group 1 and 35 min for Group 2 (p = 0.09). Length of hospital stay was similar in both groups. There were no acute or long-term complications and no need for reintervention. Transcatheter ASD closure without the use of fluoroscopy using the simplified approach is safe and effective, offers a shorter procedure duration and minimises instrumentation within the left atrium and pulmonary veins. Patient selection is key and with greater experience, this procedure may be applicable to a wider selection of ASD anatomy.

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无透视经导管房间隔缺损闭合：一种简化的方法。

回顾目的：综述无透视经导管房间隔缺损（ASD）闭合术，并介绍一种避免肺静脉介入的简化方法。最近的发现：自24年前首次报道无透视ASD关闭以来，只有少数小系列报道了这种技术。我们提出了一种简化和不那么麻烦的方法，以鼓励更广泛地采用无透视方法来适合ASD解剖。结果：9例患者采用常规方法行无透视ASD闭合术（1组），23例患者采用我们的简化方法直接将器械置入缺损处（2组）。1组中位年龄和体重为28岁，53公斤（范围：5-52岁，22-88公斤），2组中位年龄和体重为36岁，66公斤（范围：4-76岁，16-115公斤）。所有患者均成功植入器械，器械中位尺寸为21 mm（组1:9-36 mm，组2:10-33 mm）。手术时间1组为47 min， 2组为35 min （p = 0.09）。两组患者的住院时间相似。无急性或长期并发症，无需再干预。经导管ASD闭合不使用透视，使用简化的方法是安全有效的，提供了更短的手术时间，并最大限度地减少了左心房和肺静脉内的仪器。患者的选择是关键，有了更多的经验，这个程序可能适用于更广泛的ASD解剖选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.