Yıl: 2011 Cilt: 39 Sayı: 5 Sayfa Aralığı: 385 - 395 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları

Öz:
Amaç: Perkütan yolla çeşitli cihazlar kullanılarak atriyal septal defekt (ASD) ve foramen ovale açıklığı (FOA) kapatılan hastalarda kısa ve orta dönem sonuçlar değerlendirildi.Çalışma planı: Çalışmaya, sekundum tip ASD (n=134) veya FOA (n=144) nedeniyle perkütan kapatma işlemi uygulanan 278 hasta (128 erkek, 150 kadın; ort. yaş 39±12; dağılım 17-66) alındı. Tüm hastalar işlem öncesinde transtorasik (TTE) ve transözofageal (TÖE) ekokardiyografi ile değerlendirildi. Perkütan kapatma için 180 hastada Amplatzer, 92 hastada Occlutech Figulla, altı hastada BioSTAR cihazları kullanıldı. Atriyal septal defektler genel anestezi altında ve TÖE kılavuzluğunda, FOA’lar lokal anestezi altında ve TTE kılavuzluğunda kapatıldı. Hastalar 1, 6, 12. aylarda ve sonrasında yıllık olarak takip edildi. Ortalama takip süresi ASD’li olgularda 35.1±24.6 ay, FOA’lı olgularda 24.9±15.5 ay idi.Bulgular: Ortalama cihaz çapı ASD’li hastalarda 20.2±5.6 mm, FOA’lı hastalarda 24±2.9 mm (dağılım 18-28 mm) idi. Ortalama işlem süresi ASD ve FOA kapatılmasında sırasıyla 28.4±6.1 dk ve 18.2±5.3 dk, ortalama floroskopi süresi sırasıyla 4.9±2.1 dk ve 3.6±1.2 dk idi. Cihaz embolizasyonu sadece bir hastada gözlendi. Perkütan FOA kapatma uygulanan hiçbir hastada embolik olay, ASD kapatma uygulanan hastalarda tekrarlayan şant görülmedi. İki hastada işlem sırasında, bir hastada ise birinci yıl kontrolünde cihaz üzerinde trombüs görüldü.Sonuç: Amplatzer, Occlutech Figulla ve BioSTAR cihazları kullanılarak sekundum tip ASD ve FOA’lar perkütan yolla etkin ve güvenilir bir şekilde kapatılabilmektedir.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Anestezi Kalp ve Kalp Damar Sistemi Cerrahi Ortopedi

Percutaneous closure of interatrial septal defects: mid-term follow-up results

Öz:
Objectives: We evaluated short- and mid-term results of percutaneous closure of atrial septal defects (ASD) and patent foramen ovale (PFO) using various closure devices. Study design: The study included 278 patients (128 men, 150 women; mean age 39±12 years; range 17 to 66 years) who underwent percutaneous closure of secundum ASD (n=134) or PFO (n=144). All the patients were assessed by transthoracic (TTE) and transesophageal (TEE) echocardiography before the procedure. Percutaneous closure was performed with the Amplatzer (n=180), Occlutech Figulla (n=92) or BioSTAR (n=6) devices. Closure of ASDs was performed under general anesthesia with TEE guidance, and closure of PFOs was performed under local anesthesia with TTE guidance. Follow-up controls were at 1, 6, and 12 months, and annually thereafter. The mean follow-up period was 35.1±24.6 months for ASD cases, and 24.9±15.5 months for PFO cases. Results: The mean device size was 20.2±5.6 mm for ASD cases and 24±2.9 mm for PFO cases. The mean procedural and fluoroscopy times were 28.4±6.1 min and 4.9±2.1 min for ASD closure, and 18.2±5.3 min and 3.6±1.2 min for PFO closure, respectively. Procedural device embolization occurred in only one patient. No recurrent embolic events occurred after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two patients during the procedure and in one patient at one-year follow-up. Conclusion: Percutaneous closure of secundum ASDs and PFOs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an effective and safe treatment option.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Anestezi Kalp ve Kalp Damar Sistemi Cerrahi Ortopedi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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  • 1. Rome JJ, Keane JF, Perry SB, Spevak PJ, Lock JE. Double-umbrella closure of atrial defects. Initial clinical applications. Circulation 1990;82:751-8.
  • 2. Masura J, Gavora P, Formanek A, Hijazi ZM. Transcatheter closure of secundum atrial septal defects using the new self-centering Amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn 1997;42:388-93.
  • 3. Jones TK, Latson LA, Zahn E, Fleishman CE, Jacobson J, Vincent R, et al. Results of the U.S. multicenter pivotal study of the HELEX septal occluder for percutaneous closure of secundum atrial septal defects. J Am Coll Cardiol 2007;49:2215-21.
  • 4. Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K; Amplatzer Investigators. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol 2002;39:1836-44.
  • 5. Therrien J, Webb GD. Congenital heart disease in adults. In: Braunwald E, Zipes DP, Libby P, editors. Heart disease: a textbook of cardiovascular medicine. 6th ed. Philadelphia: W. B. Saunders; 2001. p. 1592-621.
  • 6. Roos-Hesselink JW, Meijboom FJ, Spitaels SE, van Domburg R, van Rijen EH, Utens EM, et al. Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age. A prospective follow-up study of 21-33 years. Eur Heart J 2003;24:190-7.
  • 7. Pascotto M, Santoro G, Cerrato F, Caputo S, Bigazzi MC, Iacono C, et al. Time-course of cardiac remodeling following transcatheter closure of atrial septal defect. Int J Cardiol 2006;112:348-52.
  • 8. Lechat P, Mas JL, Lascault G, Loron P, Theard M, Klimczac M, et al. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med 1988;318:1148-52.
  • 9. Windecker S, Wahl A, Nedeltchev K, Arnold M, Schwerzmann M, Seiler C, et al. Comparison of medical treatment with percutaneous closure of patent foramen ovale in patients with cryptogenic stroke. J Am Coll Cardiol 2004;44:750-8.
  • 10. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39:1890-900.
  • 11. Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010;31:2915-57.
  • 12. Post MC, Suttorp MJ, Jaarsma W, Plokker HW. Comparison of outcome and complications using different types of devices for percutaneous closure of a secundum atrial septal defect in adults: a single-center experience. Catheter Cardiovasc Interv 2006;67:438-43.
  • 13. Pac A, Polat TB, Çetin İ, Oflaz MB, Ballı S. Figulla ASD occluder versus Amplatzer Septal Occluder: a comparative study on validation of a novel device for percutaneous closure of atrial septal defects. J Interv Cardiol 2009; 22:489-95.
  • 14. Halabi A, Hijazi ZM. A new device to close secundum atrial septal defects: first clinical use to close multiple defects in a child. Catheter Cardiovasc Interv 2008;71:853-6.
  • 15. İlkay E, Kaçmaz F, Özeke Ö, Turan RS, Fırat S, Pampal K, et al. The efficiency and safety of percutaneous closure of secundum atrial septal defects with the Occlutech Figulla device: initial clinical experience. Türk Kardiyol Dern Arş 2010;38:189-93.
  • 16. Butera G, Romagnoli E, Saliba Z, Chessa M, Sangiorgi G, Giamberti A, et al. Percutaneous closure of multiple defects of the atrial septum: procedural results and long-term follow-up. Catheter Cardiovasc Interv 2010; 76:121-8.
  • 17. Davison P, Clift PF, Steeds RP. The role of echocardiography in diagnosis, monitoring closure and post-procedural assessment of patent foramen ovale. Eur J Echocardiogr 2010;11:i27-34.
  • 18. Hildick-Smith D, Behan M, Haworth P, Rana B, Thomas M. Patent foramen ovale closure without echocardiographic control: use of “standby” intracardiac ultrasound. JACC Cardiovasc Interv 2008;1:387-91.
  • 19. Hudsmith L, Thorne S, Clift P. Spontaneous left atrial thrombus during patent foramen ovale closure. Eur J Echocardiogr 2008;9:824.
  • 20. Hara A, Yuhki K, Fujino T, Yamada T, Takayama K, Kuriyama S, et al. Augmented cardiac hypertrophy in response to pressure overload in mice lacking the prostaglandin I2 receptor. Circulation 2005;112:84-92.
  • 21. TheHeart.org [Internet]. Wood S. CLOSURE I: PFO closure fails to beat medical therapy for stroke, TIA. June 18, 2010. Available from: http://www.theheart.org/ article/1088789.do.
  • 22. O’Gara PT, Messe SR, Tuzcu EM, Catha G, Ring JC; American Heart Association, et al. Percutaneous device closure of patent foramen ovale for secondary stroke prevention: a call for completion of randomized clinical trials: a science advisory from the American Heart Association/American Stroke Association and the American College of Cardiology Foundation. Circulation 2009;119:2743-7.
  • 23. La Rosée K, Deutsch HJ, Schnabel P, Schneider CA, Burkhard-Meier C, Höpp HW. Thrombus formation after transcatheter closure of atrial septal defect. Am J Cardiol 1999;84:356-9.
  • 24. Hanzel GS. Complications of patent foramen ovale and atrial septal defect closure devices. J Interv Cardiol 2006; 19:160-2.
  • 25. Krumsdorf U, Ostermayer S, Billinger K, Trepels T, Zadan E, Horvath K, et al. Incidence and clinical course of thrombus formation on atrial septal defect and patient foramen ovale closure devices in 1,000 consecutive patients. J Am Coll Cardiol 2004;43:302-9
  • 26. Chessa M, Carminati M, Butera G, Bini RM, Drago M, Rosti L, et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 2002;39:1061-5.
  • 27. Acar P, Aggoun Y, Abdel-Massih T. Images in cardiology: Thrombus after transcatheter closure of ASD with an Amplatzer septal occluder assessed by three dimensional echocardiographic reconstruction. Heart 2002; 88:52.
  • 28. Vanderheyden M, Willaert W, Claessens P, Branders I, Ex P, Vermeersch P. Thrombosis of a patent foramen ovale closure device: thrombolytic management. Catheter Cardiovasc Interv 2002;56:522-6.
  • 29. Willcoxson FE, Thomson JD, Gibbs JL. Successful treatment of left atrial disk thrombus on an Amplatzer atrial septal defect occluder with abciximab and heparin. Heart 2004;90:e30.
  • 30. Eren NK, Akyıldız Zİ, Acet H, Ertaş F, Nazlı C, Ergene O. Thrombus formation on the delivery sheath during transcatheter atrial septal defect closure. Tex Heart Inst J 2009;36:624-5.
  • 31. Mullen MJ, Hildick-Smith D, De Giovanni JV, Duke C, Hillis WS, Morrison WL, et al. BioSTAR Evaluation STudy (BEST): a prospective, multicenter, phase I clinical trial to evaluate the feasibility, efficacy, and safety of the BioSTAR bioabsorbable septal repair implant for the closure of atrial-level shunts. Circulation 2006;114:1962-7.
  • 32. Brown S, Gewillig M. Perforation of the aortic sinus after closure of atrial septal defects with the Atriasept occluder. Catheter Cardiovasc Interv 2009;74:298-301.
  • 33. Amin Z, Hijazi ZM, Bass JL, Cheatham JP, Hellenbrand WE, Kleinman CS. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv 2004;63:496-502.
  • 34. El-Said HG, Moore JW. Erosion by the Amplatzer septal occluder: experienced operator opinions at odds with manufacturer recommendations? Catheter Cardiovasc Interv 2009;73:925-30.
  • 35. Giardini A, Donti A, Formigari R, Bronzetti G, Prandstraller D, Bonvicini M, et al. Comparison of results of percutaneous closure of patent foramen ovale for paradoxical embolism in patients with versus without thrombophilia. Am J Cardiol 2004;94:1012-6.
  • 36. Rigatelli G, Dell’Avvocata F, Giordan M, Camerotto A, Panin S, Ronco F, et al. Safety and long-term results of patent foramen ovale transcatheter closure in patients with thrombophilia. Minerva Cardioangiol 2009;57:285-9.
  • 37. Opotowsky AR, Landzberg MJ, Kimmel SE, Webb GD. Percutaneous closure of patent foramen ovale and atrial septal defect in adults: the impact of clinical variables and hospital procedure volume on in-hospital adverse events. Am Heart J 2009;157:867-74.
APA OTO M, AYTEMIR K, ÖZKUTLU S, KAYA E, KABAKÇI G, ATEŞ A, YORGUN H, CANPOLAT U (2011). İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. , 385 - 395.
Chicago OTO M. Ali,AYTEMIR KUDRET,ÖZKUTLU Süheyla,KAYA ERGUN BARIS,KABAKÇI Giray,ATEŞ AHMET HAKAN,YORGUN HIKMET,CANPOLAT Uğur İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. (2011): 385 - 395.
MLA OTO M. Ali,AYTEMIR KUDRET,ÖZKUTLU Süheyla,KAYA ERGUN BARIS,KABAKÇI Giray,ATEŞ AHMET HAKAN,YORGUN HIKMET,CANPOLAT Uğur İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. , 2011, ss.385 - 395.
AMA OTO M,AYTEMIR K,ÖZKUTLU S,KAYA E,KABAKÇI G,ATEŞ A,YORGUN H,CANPOLAT U İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. . 2011; 385 - 395.
Vancouver OTO M,AYTEMIR K,ÖZKUTLU S,KAYA E,KABAKÇI G,ATEŞ A,YORGUN H,CANPOLAT U İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. . 2011; 385 - 395.
IEEE OTO M,AYTEMIR K,ÖZKUTLU S,KAYA E,KABAKÇI G,ATEŞ A,YORGUN H,CANPOLAT U "İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları." , ss.385 - 395, 2011.
ISNAD OTO, M. Ali vd. "İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları". (2011), 385-395.
APA OTO M, AYTEMIR K, ÖZKUTLU S, KAYA E, KABAKÇI G, ATEŞ A, YORGUN H, CANPOLAT U (2011). İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. Türk Kardiyoloji Derneği Arşivi, 39(5), 385 - 395.
Chicago OTO M. Ali,AYTEMIR KUDRET,ÖZKUTLU Süheyla,KAYA ERGUN BARIS,KABAKÇI Giray,ATEŞ AHMET HAKAN,YORGUN HIKMET,CANPOLAT Uğur İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. Türk Kardiyoloji Derneği Arşivi 39, no.5 (2011): 385 - 395.
MLA OTO M. Ali,AYTEMIR KUDRET,ÖZKUTLU Süheyla,KAYA ERGUN BARIS,KABAKÇI Giray,ATEŞ AHMET HAKAN,YORGUN HIKMET,CANPOLAT Uğur İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. Türk Kardiyoloji Derneği Arşivi, vol.39, no.5, 2011, ss.385 - 395.
AMA OTO M,AYTEMIR K,ÖZKUTLU S,KAYA E,KABAKÇI G,ATEŞ A,YORGUN H,CANPOLAT U İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. Türk Kardiyoloji Derneği Arşivi. 2011; 39(5): 385 - 395.
Vancouver OTO M,AYTEMIR K,ÖZKUTLU S,KAYA E,KABAKÇI G,ATEŞ A,YORGUN H,CANPOLAT U İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları. Türk Kardiyoloji Derneği Arşivi. 2011; 39(5): 385 - 395.
IEEE OTO M,AYTEMIR K,ÖZKUTLU S,KAYA E,KABAKÇI G,ATEŞ A,YORGUN H,CANPOLAT U "İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları." Türk Kardiyoloji Derneği Arşivi, 39, ss.385 - 395, 2011.
ISNAD OTO, M. Ali vd. "İnteratriyal septal defektlerin perkütan yolla kapatılması: Orta dönem izlem sonuçları". Türk Kardiyoloji Derneği Arşivi 39/5 (2011), 385-395.