Adult Congenital Heart Disease and Percutaneous Interventions : Analysis of Cases over five years in a Bangladeshi Center

N. Fatema
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Abstract

Background: In recent year ‘s considerable progress has been made in the early diagnosis and treatment of congenital heart disease (CHD) and a significant number of children are expected to survive into adulthood after completion of treatment. This has created a scope of a substantial population of patients with adult congenital heart disease. In Bangladesh, milder or simple from of congenital heart diseases are prevalent among populations but palliated and treated cases of CHD are gradually increasing the load of work for adult congenital heart disease (ACHD) professionals. Many of these cases can be treated by transcatheter intervention with excellent outcome. Methods: This is a retrospective study conducted in a tertiary level cardiac hospitals of Bangladesh from January 2015 to December 2020. All cases aging 18 years and above were included who had undergone cardiac catheterization or percutaneous interventions. Data were collected from Echocardiography department, Catheterization Laboratory and indoor department. Follow up data were collected from echocardiography and outpatient department. Results: Total Two hundred Ninety-four cases were enrolled for cardiac catheterization. Two hundred eighteen cases had various types of intervention. Most of the cases were in 18-25 years age group. Among shunt lesions, 165 cases (56.12%) had atrial septal defect (ASD), 48(22.02%) had ventricular septal defect (VSD), 32 (14.67%) had patent ductus arteriosus (PDA), and 4(1.83%) had patent foramen ovale (PFO). Device closure was performed in 120(55.04%) cases of ASD, 13(5.96%) cases of VSD, 30 (13.76%) cases of PDA and in 4(1.83%) cases of PFO. Nineteen (8.72%) had valvuloplasty for pulmonary stenosis (PS), 2 (0.68%) had valvuloplasty for aortic stenosis (AS), 2(0.068%) had coarctoplasty for coarctation of the aorta (CoA), 4 (1.83%) had percutaneous pulmonary valve implantation (PPVI). Seventeen (7.79%) cases had double intervention of ASD device closure and pulmonary stenosis, 5 (2,29%) cases had ASD and PDA device closure and 2 (0.92%) cases had PDA device closure and balloon coarctoplasty. ASD device was embolized in 4 cases. There were no other complications. Conclusion: Outcome of intervention in ACHD was found safe and effective and no significant short or long-term complications were noticed. Cardiovasc j 2022; 14(2): 121-127
成人先天性心脏病和经皮介入治疗:孟加拉国中心五年来的病例分析
背景:近年来,在先天性心脏病(CHD)的早期诊断和治疗方面取得了相当大的进展,相当多的儿童在完成治疗后有望存活到成年。这为成人先天性心脏病患者创造了一个相当大的人群范围。在孟加拉国,较轻或单纯的先天性心脏病在人群中很普遍,但冠心病得到缓解和治疗的病例正逐渐增加成人先天性心脏病专业人员的工作量。许多此类病例可经导管介入治疗,效果良好。方法:回顾性研究于2015年1月至2020年12月在孟加拉国一家三级心脏医院进行。所有年龄在18岁及以上的患者均接受过心导管插入术或经皮介入治疗。数据来自超声心动图科、导管室和室内科。随访资料收集自超声心动图和门诊。结果:共纳入294例心导管插入术。218个病例进行了不同类型的干预。病例以18 ~ 25岁年龄组居多。分流病变中,房间隔缺损165例(56.12%),室间隔缺损48例(22.02%),动脉导管未闭32例(14.67%),卵圆孔未闭4例(1.83%)。ASD 120例(55.04%),VSD 13例(5.96%),PDA 30例(13.76%),PFO 4例(1.83%)。肺动脉狭窄瓣膜成形术19例(8.72%),主动脉狭窄瓣膜成形术2例(0.68%),主动脉缩窄瓣膜成形术2例(0.068%),经皮肺动脉瓣植入术4例(1.83%)。ASD闭锁合并肺动脉狭窄双介入17例(7.79%),ASD闭锁合并PDA 5例(2.29%),PDA闭锁合并气囊成形术2例(0.92%)。ASD装置栓塞4例。没有其他并发症。结论:ACHD的干预结局安全有效,无明显的短期或长期并发症。心血管病杂志[j] 2022;14 (2): 121 - 127
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