G. Albenque, E. Valdeolmillos, C. Foray, M. Jaber, F. Lecerf, E. Belli, C. Batteux, J. Petit, S. Hascoët
{"title":"2253 名儿童和成人经导管关闭房间隔缺损（ostium secundum atrial septal defects）后发生重大不良事件的形态学风险指标","authors":"G. Albenque, E. Valdeolmillos, C. Foray, M. Jaber, F. Lecerf, E. Belli, C. Batteux, J. Petit, S. Hascoët","doi":"10.1016/j.acvd.2024.07.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Since the 2000s, transcatheter closure has been the primary treatment for ostium secundum atrial septal defect (osASD) in children and adults.</p></div><div><h3>Objective</h3><p>This study aims to identify factors associated with short-term adverse outcomes following this procedure in a large cohort.</p></div><div><h3>Methods</h3><p>A prospective, single-center cohort study included 2,253 consecutive patients (median age 28<!--> <!-->years; children: <em>n</em> <!-->=<!--> <!-->865, 38.4%) who underwent transcatheter ASD closure with the Amplatzer Septal Occluder (ASO; Amplatzer™ Atrial Septal Occluder Device, Abbott, Chicago, USA) from May 1998 to December 2021. Peri-procedural data associated with major adverse events were investigated retrospectively.</p></div><div><h3>Results</h3><p>The mean ASD diameter, as measured by transthoracic echocardiography, was 18<!--> <!-->mm. About 8.9% of patients had an ASD size-to-body surface area (BSA) ratio of<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup>. Deficient rims (<<!--> <!-->5<!--> <!-->mm) were identified in 27.9% of patients, with retroaortic rim deficiency in 22.7% and inferior rim deficiency in 0.9%. The median ASO diameter was 24<!--> <!-->mm, with a procedural success rate of 98.2%. ASD/BSA<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup> was associated with procedural failure, while age and weight were not. Major peri-procedural adverse events occurred in 31 patients (1.4%), with 19 device embolizations and 2 cardiac erosions. No peri-procedural deaths were reported. Multivariate analysis showed that deficiency of the inferior vena cava rim and an ASD size/BS ratio<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup> were significantly associated with major adverse events (<em>P</em> <!-->=<!--> <!-->0.002 and <em>P</em> <!-->=<!--> <!-->0.035, respectively) (<span><span>Fig. 1</span></span>).</p></div><div><h3>Conclusion</h3><p>Transcatheter osASD closure using ASO is safe and effective in a large spectrum population with low rate of peri-procedural adverse events and favorable short-term outcomes. ASD size-to-body surface area ratio (≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup>) and inferior rim deficiency are key morphological risk markers for major adverse events following this procedure.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S227"},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Morphological risk markers for major adverse events following transcatheter closure of ostium secundum atrial septal defects in 2253 children and adults\",\"authors\":\"G. Albenque, E. Valdeolmillos, C. Foray, M. Jaber, F. Lecerf, E. Belli, C. Batteux, J. Petit, S. Hascoët\",\"doi\":\"10.1016/j.acvd.2024.07.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Since the 2000s, transcatheter closure has been the primary treatment for ostium secundum atrial septal defect (osASD) in children and adults.</p></div><div><h3>Objective</h3><p>This study aims to identify factors associated with short-term adverse outcomes following this procedure in a large cohort.</p></div><div><h3>Methods</h3><p>A prospective, single-center cohort study included 2,253 consecutive patients (median age 28<!--> <!-->years; children: <em>n</em> <!-->=<!--> <!-->865, 38.4%) who underwent transcatheter ASD closure with the Amplatzer Septal Occluder (ASO; Amplatzer™ Atrial Septal Occluder Device, Abbott, Chicago, USA) from May 1998 to December 2021. Peri-procedural data associated with major adverse events were investigated retrospectively.</p></div><div><h3>Results</h3><p>The mean ASD diameter, as measured by transthoracic echocardiography, was 18<!--> <!-->mm. About 8.9% of patients had an ASD size-to-body surface area (BSA) ratio of<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup>. Deficient rims (<<!--> <!-->5<!--> <!-->mm) were identified in 27.9% of patients, with retroaortic rim deficiency in 22.7% and inferior rim deficiency in 0.9%. The median ASO diameter was 24<!--> <!-->mm, with a procedural success rate of 98.2%. ASD/BSA<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup> was associated with procedural failure, while age and weight were not. Major peri-procedural adverse events occurred in 31 patients (1.4%), with 19 device embolizations and 2 cardiac erosions. No peri-procedural deaths were reported. Multivariate analysis showed that deficiency of the inferior vena cava rim and an ASD size/BS ratio<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup> were significantly associated with major adverse events (<em>P</em> <!-->=<!--> <!-->0.002 and <em>P</em> <!-->=<!--> <!-->0.035, respectively) (<span><span>Fig. 1</span></span>).</p></div><div><h3>Conclusion</h3><p>Transcatheter osASD closure using ASO is safe and effective in a large spectrum population with low rate of peri-procedural adverse events and favorable short-term outcomes. ASD size-to-body surface area ratio (≥<!--> <!-->20<!--> <!-->mm/m<sup>2</sup>) and inferior rim deficiency are key morphological risk markers for major adverse events following this procedure.</p></div>\",\"PeriodicalId\":55472,\"journal\":{\"name\":\"Archives of Cardiovascular Diseases\",\"volume\":\"117 8\",\"pages\":\"Page S227\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Cardiovascular Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1875213624002377\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1875213624002377","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Morphological risk markers for major adverse events following transcatheter closure of ostium secundum atrial septal defects in 2253 children and adults
Introduction
Since the 2000s, transcatheter closure has been the primary treatment for ostium secundum atrial septal defect (osASD) in children and adults.
Objective
This study aims to identify factors associated with short-term adverse outcomes following this procedure in a large cohort.
Methods
A prospective, single-center cohort study included 2,253 consecutive patients (median age 28 years; children: n = 865, 38.4%) who underwent transcatheter ASD closure with the Amplatzer Septal Occluder (ASO; Amplatzer™ Atrial Septal Occluder Device, Abbott, Chicago, USA) from May 1998 to December 2021. Peri-procedural data associated with major adverse events were investigated retrospectively.
Results
The mean ASD diameter, as measured by transthoracic echocardiography, was 18 mm. About 8.9% of patients had an ASD size-to-body surface area (BSA) ratio of ≥ 20 mm/m2. Deficient rims (< 5 mm) were identified in 27.9% of patients, with retroaortic rim deficiency in 22.7% and inferior rim deficiency in 0.9%. The median ASO diameter was 24 mm, with a procedural success rate of 98.2%. ASD/BSA ≥ 20 mm/m2 was associated with procedural failure, while age and weight were not. Major peri-procedural adverse events occurred in 31 patients (1.4%), with 19 device embolizations and 2 cardiac erosions. No peri-procedural deaths were reported. Multivariate analysis showed that deficiency of the inferior vena cava rim and an ASD size/BS ratio ≥ 20 mm/m2 were significantly associated with major adverse events (P = 0.002 and P = 0.035, respectively) (Fig. 1).
Conclusion
Transcatheter osASD closure using ASO is safe and effective in a large spectrum population with low rate of peri-procedural adverse events and favorable short-term outcomes. ASD size-to-body surface area ratio (≥ 20 mm/m2) and inferior rim deficiency are key morphological risk markers for major adverse events following this procedure.
期刊介绍：
The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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