Relevant bibliographies by topics / Atrial septal defects

Academic literature on the topic 'Atrial septal defects'

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Published: 4 June 2021
Last updated: 1 February 2022

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Journal articles on the topic "Atrial septal defects"

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Sandeep, Nefthi, and Michael C. Slack. "Percutaneous management of coronary sinus atrial septal defect: two cases representing the spectrum for device closure and a review of the literature." Cardiology in the Young 24, no. 5 (March 25, 2014): 797–806. http://dx.doi.org/10.1017/s1047951114000353.

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AbstractCoronary sinus atrial septal defects are the rarest defects of the atrial septum comprising <1% of the five different types of atrial septal defects. Despite the widespread adoption of percutaneous device closure of secundum atrial septal defects, the published experience with percutaneous device closure of coronary sinus atrial septal defects is limited to only a few isolated case reports because of uncertainty regarding safety and efficacy. Open-heart surgical repair remains the treatment of choice for coronary sinus atrial septal defects, although this may not be the only treatment option in selected cases. Herein we describe our own experience with two patients with different clinical presentations and our method of successful percutaneous coronary sinus atrial septal defect closure in each. We then present a review of the anatomic spectrum of coronary sinus atrial septal defects along with a review of contemporary surgical and percutaneous device treatment.
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Geva, Tal, Jose D. Martins, and Rachel M. Wald. "Atrial septal defects." Lancet 383, no. 9932 (May 2014): 1921–32. http://dx.doi.org/10.1016/s0140-6736(13)62145-5.

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Zeller, John L., Cassio Lynm, and Richard M. Glass. "Atrial Septal Defects." JAMA 296, no. 24 (December 27, 2006): 3036. http://dx.doi.org/10.1001/jama.296.24.3036.

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Siddiqui, M. A. "Atrial septal defects." Cleveland Clinic Journal of Medicine 61, no. 6 (November 1, 1994): 473. http://dx.doi.org/10.3949/ccjm.61.6.473.

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Lowery, Kristyn S. "Atrial Septal Defects." Physician Assistant Clinics 1, no. 4 (October 2016): 553–62. http://dx.doi.org/10.1016/j.cpha.2016.05.004.

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Tarasov, D. G., I. V. Tkachev, and S. S. Kadrabulatova. "The role of three-dimensional transesophageal echocardiography in preoperative assessment of atrial septal defects." Patologiya krovoobrashcheniya i kardiokhirurgiya 18, no. 1 (October 10, 2015): 58. http://dx.doi.org/10.21688/1681-3472-2014-1-58-61.

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An atrial septal defect is the most common congenital heart disease. Transcatheter defect closure has become widespread in recent times and the requirements for this procedure are rather strict. Two-dimensional echocardiography is limited in evaluating atrial septal defects because it provides planar images only. In order to preoperatively assess atrial septal defects, we applied three-dimensional transesophageal echocardiography and then compared the results with those of surgical operations. The maximum diameter, shape, area and localization of the atrial septal defect in 26 patients were estimated with three-dimensional echocardiography. It was found out that positive correlation existed between three-dimensional echocardiography findings and those measured during surgery. Three-dimensional echocardiography provides invaluable assistance in preoperative evaluation of atrial septal defects and in selection of treatment.
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Cho, Eun Hyun, Jinyoung Song, Eun Young Choi, and Sang Yoon Lee. "Device Size for Transcatheter Closure of Ovoid Interatrial Septal Defect." Heart Surgery Forum 16, no. 4 (August 19, 2013): 193. http://dx.doi.org/10.1532/hsf98.20121131.

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<p><b>Background:</b> For successful transcatheter closure of an atrial septal defect with the Amplatzer septal occluder, the shape of the defect should be considered before selecting the device size. The purpose of this study was to evaluate the results of transcatheter closure of an ovoid atrial septal defect.</p><p><b>Methods:</b> Between January 2010 and February 2012, cardiac computer tomography examinations were performed in 78 patients who subsequently underwent transcatheter closure of an atrial septal defect. In this retrospective study, we reviewed these patients' medical records. We defined an ovoid atrial septal defect as a value of 0.75 for the ratio of the shortest diameter of the defect to the longest diameter, as measured in a computed tomography image. Transthoracic echocardiography examinations were made at 1 day and 6 months after the procedure.</p><p><b>Results:</b> Transcatheter closure of an atrial septal defect was successful in 26 patients in the ovoid-defect group and in 52 patients in the round-defect group. There were no serious complications in either group, and the rate of complete closure at 6 months was 92.3% in the ovoid-defect group and 93.1% in the round-defect group (<i>P ></i> .05). The mean (SD) difference between the device size and the defect's longest diameter, and the mean ratio of the device size to the longest diameter were significantly smaller in the ovoid-defect group (1.7 � 2.9 versus 3.8 � 2.5 and 1.1 � 0.1 versus 1.3 � 0.2, respectively).</p><p><b>Conclusions:</b> Transcatheter closure of an atrial septal defect is indicated even for an ovoid atrial septal defect. Ovoid atrial septal defects can be closed successfully with smaller sizes of the Amplatzer septal occluder than for round atrial septal defects.</p>
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Gowda, Ramesh M., Ijaz A. Khan, Vithaya Chaithiraphan, Paul Stelzer, Lawrence M. Boxt, Balendu C. Vasavada, and Hugo Rosero. "Atrial Septal Aneurysm with Multiple Atrial Septal Defects: Cribriform Atrial Septal Aneurysm." Cardiology 104, no. 1 (2005): 22–23. http://dx.doi.org/10.1159/000086049.

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Tanghöj, Gustaf, Petru Liuba, Gunnar Sjöberg, and Estelle Naumburg. "Risk factors for adverse events within one year after atrial septal closure in children: a retrospective follow-up study." Cardiology in the Young 30, no. 3 (December 18, 2019): 303–12. http://dx.doi.org/10.1017/s1047951119002919.

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AbstractIntroduction:Secundum atrial septal defect is one of the most common congenital heart defects. Previous paediatric studies have mainly addressed echocardiographic and few clinical factors among children associated with adverse events. The aim of this study was to identify neonatal and other clinical risk factors associated with adverse events up to one year after closure of atrial septal defect.Methods:This retrospective case–control study includes children born in Sweden between 2000 and 2014 that were treated surgically or percutaneously for an atrial septal defect. Conditional logistic regression was used to evaluate the association between major and minor adverse events and potential risk factors, adjusting for confounding factors including prematurity, neonatal sepsis, neonatal general ventilatory support, symptomatic atrial septal defects, and pulmonary hypertension.Results:Overall, 396 children with 400 atrial septal defect closures were included. The median body weight at closure was 14.5 (3.5–110) kg, and the median age was 3.0 (0.1–17.8) years. Overall, 110 minor adverse events and 68 major events were recorded in 87 and 49 children, respectively. Only symptomatic atrial septal defects were associated with both minor (odds ratio (OR) = 2.18, confidence interval (CI) 95% 1.05–8.06) and major (OR = 2.80 CI 95% 1.23–6.37) adverse events.Conclusion:There was no association between the investigated neonatal comorbidities and major or minor events after atrial septal defect closure. Patients with symptomatic atrial septal defects had a two to four times increased risk of having a major event, suggesting careful management and follow-up of these children prior to and after closure.
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Rao, P. Syamasundar, and Andrea D. Harris. "Recent advances in managing septal defects: atrial septal defects." F1000Research 6 (November 22, 2017): 2042. http://dx.doi.org/10.12688/f1000research.11844.1.

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The purpose of this review is to discuss the management of atrial septal defects (ASD), paying particular attention to the most recent developments. There are four types of ASDs: ostium secundum, ostium primum, sinus venosus, and coronary sinus defects. The fifth type, patent foramen ovale—which is present in 25 to 30% of normal individuals and considered a normal variant, although it may be the seat of paradoxical embolism, particularly in adults—is not addressed in this review. The indication for closure of the ASDs, by and large, is the presence of right ventricular volume overload. In asymptomatic patients, the closure is usually performed at four to five years of age. While there was some earlier controversy regarding ASD closure in adult patients, currently it is recommended that the ASD be closed at the time of presentation. Each of the four defects is briefly described followed by presentation of management, whether by surgical or percutaneous approach, as the case may be. Of the four types of ASDs, only the ostium secundum defect is amenable to percutaneous occlusion. For ostium secundum defects, transcatheter closure has been shown to be as effective as surgical closure but with the added benefits of decreased hospital stay, avoidance of a sternotomy, lower cost, and more rapid recovery. There are several FDA-approved devices in use today for percutaneous closure, including the Amplatzer® Septal Occluder (ASO), Amplatzer® Cribriform device, and Gore HELEX® device. The ASO is most commonly used for ostium secundum ASDs, the Gore HELEX® is useful for small to medium-sized defects, and the cribriform device is utilized for fenestrated ASDs. The remaining types of ASDs usually require surgical correction. All of the available treatment modes are safe and effective and prevent the development of further cardiac complications.
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Dissertations / Theses on the topic "Atrial septal defects"

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Ching, Yung-Hao. "Molecular genetics of human atrial septal defects." Thesis, University of Nottingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246413.

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Kirk, Edwin Philip Enfield Women's &amp Children's Health Faculty of Medicine UNSW. "The genetics of atrial septal defect and patent foramen ovale." Awarded by:University of New South Wales, 2007. http://handle.unsw.edu.au/1959.4/34759.

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Congenital heart disease is the most common form of birth defect, affecting approximately 1% of liveborn babies. Secundum atrial septal defect (ASD) is the second most common form of congenital heart disease (CHD). Most cases have no known cause. Chromosomal, syndromal and teratogenic causes account for a minority of cases. The hypothesis that mutations in the ASD genes NKX2-5 and GATA4 may cause apparently sporadic ASD was tested by sequencing them in unrelated probands with ASD. In this study, 1/102 individuals with ASD had an NKX2-5 mutation, and 1/129 had a deletion of the GATA4 gene. The cardiac transcription factor TBX20 interacts with other ASD genes but had not previously been associated with human disease. Of 352 individuals with CHD, including 175 with ASD, 2 individuals, each with a family history of CHD, had pathogenic mutations in TBX20. Phenotypes included ASD, VSD, valvular abnormalities and dilated cardiomyopathy. These studies of NKX2-5, GATA4 and TBX20 indicate that dominant ASD genes account for a small minority of cases of ASD, and emphasize the considerable genetic heterogeneity in dominant ASD (also caused by mutations in MYH6 and ACTC). A new syndrome of dominant ASD and the Marcus Gunn jaw winking phenomenon is reported. Linkage to known loci was excluded, extending this heterogeneity, but a whole genome scan did not identify a candidate locus for this disorder. Previous studies of inbred laboratory mice showed an association between patent foramen ovale (PFO) and measures of atrial septal morphology, particularly septum primum length (???flap valve length??? or FVL). In humans, PFO is associated with cryptogenic stroke and migraine, and is regarded as being in a pathological contiuum with ASD. Twelve inbred strains, including 129T2/SvEms and QSi5, were studied, with generation of [129T2/SvEms x QSi5] F1, F2 and F14 mice. Studies of atrial morphology in 3017 mice confirmed the relationship between FVL and PFO but revealed considerable complexity. An F2 mapping study identified 7 significant and 6 suggestive quantitative trait loci (QTL), affecting FVL and two other traits, foramen ovale width (FOW) and crescent width (CRW). Binary analysis of PFO supported four of these.
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Johansson, Magnus. "Diagnosis of interatrial shunts and the influence of patent foramen ovale on oxygen desaturation in obstructive sleep apnea /." Göteborg : Department of Clinical Physiology, Department of Emergency and Cardiovascular Medicine, Sahlgrenska University Hospital/Östra, Institute of Medicine, The Sahlgrenska Academy at Göteborg University, 2007. http://hdl.handle.net/2077/7470.

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Marchi, Carlos Henrique de. "Monitoração ecocardiográfica da atriosseptostomia com balão." Faculdade de Medicina de São José do Rio Preto, 2004. http://bdtd.famerp.br/handle/tede/186.

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Made available in DSpace on 2016-01-26T12:51:45Z (GMT). No. of bitstreams: 1 carlosdemarchi_tese.pdf: 849020 bytes, checksum: f72fc171abbb042bef869d955b6fd632 (MD5) Previous issue date: 2004-09-10
Objective: Balloon atrial septostomy (BAS) is a life-saving palliative procedure for some congenital heart defects and typically performed in the cardiac catheterization laboratory. The aim of this study was to evaluate BAS under echocardiographic guidance. Method: From August 1997 through January 2004, 31 children with congenital heart defects with indication of ASB were submitted to the procedure under exclusive echocardiographic guidance. Success was admitted the obtaining of atrial septal defect (ASD) with size of four millimeters (mm) or greater and torn septal tissue flapping freely. Results: Male infants predominated (83.9%). Median age was 5 days (1 - 150) and median weight was 3300g (1800 - 7500). Transposition of the Great Arteries was present in 80.6%, Tricuspid Atresia in 12.9%, Total Anomalous Pulmonary Venous Return in 3.2% and Pulmonary Atresia with intact ventricular septum in 3.2%. The procedure was successful in all cases. ASD size increased from 1.8 ± 0.8 mm to 5.8 ± 1.3 mm (P<0.0001) and arterial oxygen saturation increased from 64.5 ± 18.9% to 85.1 ± 9.2% (P<0.0001). As complications occured three balloon ruptures, one tear of right femoral vein, one case of supraventricular tachycardia and one case of atrial flutter. Conclusion: BAS under echocardiographic guidance is a safe and effective method. It can be performed at the bedside, identifies the catheter location avoiding serious complications and evaluates the immediate result of the procedure.
Atnosseptostomia com balão (ASB) é procedimento de grande valor no tratamento de cardiopatias congênitas e monitorado tradicionalmente por radioscopia. O objetivo do presente estudo foi avaliar a ASB monitorada pela ecocardiografia. Casuística e Método: Entre agosto de 1997 e janeiro de 2004, 31 crianças foram submetidas à ASB sob monitoração ecocardiográfica exclusiva. Admitiu-se sucesso a obtenção de comunicação interatrial (CIA) com diâmetro igual ou maior que quatro milímetros (mm) e com ampla mobilidade das suas margens. Dados coletados: diâmetro da CIA e saturação arterial de oxigênio (SAT) iniciais e finais e número de trações do cateter balão. Resultados: Sexo masculino predominou (83,9%). A idade mediana foi de 5 dias (1-150) e o peso teve mediana de 3300g (1800-7500). Transposição das Grandes Artérias ocorreu em 80,6%, Atresia Tricúspide em 12,9%, Drenagem Anômala Total de Veias Pulmonares em 3,2% e Atresia Pulmonar com septo Integro em 3,2%. Sucesso foi obtido em todos os casos. O tamanho da CIA aumentou de 1,8 0,8 mm para 5,8 1,3 mm (p <0,0001) e a SAT aumentou de 64,5 18,9 % para 85,1 9,2 % (p < 0,0001). Complicações ocorridas: três rupturas de balão, uma lesão de veia femoral direita, uma taquicardia supraventricular e um flutter atnal. Conclusões: ASB monitorada pela ecocardiografia é método seguro e eficaz. Possibilita a realização do procedimento à beira do leito evitando o transporte da criança, identifica o posicionamento do cateter reduzindo complicações graves e avalia o resultado imediato do procedimento.
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Jalal, Zakaria. "Evaluation multimodale du processus de cicatrisation des dispositifs de fermeture percutanée des communications inter-atriales." Thesis, Bordeaux, 2018. http://www.theses.fr/2018BORD0235/document.

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La fermeture percutanée est le traitement de référence des communications interatriales (CIA). Après son implantation, une cicatrisation du dispositif est classiquement attendue après quelques mois ; il semble cependant qu’un recouvrement incomplet ou partiel puisse être observé dans de rares cas, sans que l’on en connaisse les mécanismes impliqués. Cette cicatrisation imparfaite du dispositif est associée à la survenue de complications retardées. Dans le cadre de cette thèse nous avons étudié la cicatrisation de ces prothèses de CIA, en nous focalisant sur les processus de recouvrement et d’endothélialisation des dispositifs, à travers une approche translationnelle incluant expérimentations in vitro, modèle animal chronique et étude clinique. A la fin de ce travail, il est possible de conclure que : 1) il existe des cas de complications au long cours après fermeture de CIA, liées à un défaut de recouvrement du dispositif, 2) sur une large cohorte pédiatrique avec un suivi allant jusqu’à 18 ans après l’implantation, l’incidence de ces complications est faible 3) les modèles animaux, utilisés seuls, ne peuvent suffire à expliquer ni à avancer dans la compréhension de ce phénomène, 4) il n’existe pas de différences significatives concernant le processus de recouvrement entre les 3 prothèses analysées au cours de ce travail, 5) une évaluation non invasive et individualisée du recouvrement prothétique , grâce aux techniques d’imagerie, est une perspective prometteuse. Ces données montrent qu’une meilleure compréhension du processus de recouvrement prothétique passe par la réalisation conjointe d’études fondamentales et cliniques. Cependant, le développement d’outils permettant une évaluation individualisée du recouvrement doit être poursuivi, du fait de leur fort potentiel de translation clinique et de leur capacité à optimiser la prise en charge du patient
The percutaneous device closure is the gold treatment of atrial septal defect (ASD). After implantation, device healing is classically expected following several months; however, an incomplete or partial covering of the device may be observed without a full knowledge of the underlying mechanisms. In this thesis we studied the healing of these intracardiac prostheses, focusing on the covering and endothelialization processes of devices, approach through a translational approach including in vitro experiments, chronic animal model and clinical study. At the end of this work, it is possible to conclude that 1) there are cases of long-term complications after closure of CIA, related to a lack of recovery of the device, 2) in a large cohort of pediatric with a follow up of up to at 18 years after implantation, the incidence of these complications is low 3) animal models, used alone, can not suffice to explain or improve the understanding of this complex process, 4) there is no significant differences in the covering process between the 3 prostheses analyzed during this work, 5) a non-invasive and individualized assessment of prosthetic recovery, using imaging techniques, is a promising perspective with significant potential for clinical translation . These data show that a better understanding of device healing process needs the joint undertake of basic and clinical studies. Moreover, the development of tools for individualized assessment of device covering should be pursued in parallel, due to their high translational potential, in order to optimize patient management
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Thomson, John D. R. "Markers of neurological damage and atrial septal defect closure." Thesis, University of Leeds, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.507883.

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TAKEUCHI, Eiji, Minoru TANAKA, Toshio ABE, and Yoshio KANO. "Electrophysiological abnormalities before and after surgery for atrial septal defect." Thesis, Elsevier, 1993. http://hdl.handle.net/2237/16688.

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Tarutis, Virgilijus. "Mažiau invazinė įgimtų širdies ydų chirurgija. Širdies pertvarų defektų korekcijos įvertinimas." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2009. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2009~D_20090707_155038-43427.

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Darbe išnagrinėti mažiau invazinės įgimtų prieširdžių pertvaros defektų (PPD) ir skilvelių pertvaros defektų (SPD) ydų chirurgijos galimybės ir ypatumai. Standartinį šių ydų operavimo būdą per išilginę vidurinę sternotomiją galima pakeisti mažiau invaziniu su geresniu kosmetiniu rezultatu. Darbe parodoma, kad mažiau invazinių PPD ir SPD korekcijų rizika iš esmės nesiskiria nuo standartinės metodikos per vidurinę išilginę sternotomiją. Mažiau invazinių širdies pertvarų defektų uždarymo operacijų metodika įgalina jas saugiai atlikti su įprastiniais širdies chirurgijos instrumentais be papildomų išlaidų. Mažiau invazinių įgimtų širdies ydų operacijų indikacijos yra siauresnės.
The study defines the possibilities and peculiarities of the less invasive congenital atrial septal defect (ASD) and ventricular septal defect (VSD) surgery. A standard median sternotomy approach in some cases is possible to replace with more cosmetic friendly and less invasive access. The study demonstrates that the risk of less invasive ASD and VSD closure doesn’t differ from the standard median sternotomy surgery risk. Less invasive operations methodic used in our centre enables it with conventional instrumentary set. Indications for less invasive congenital heart defects surgery are narrower.
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Jacob, Maria Fernanda Ferrari Balthazar. "Prevalência de hipertensão pulmonar e evolução dos pacientes submetidos à correção de defeito do septo atrioventricular no Serviço de Cardiologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/17/17144/tde-25072018-104511/.

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Doenças cardíacas congênitas são as mais frequentes entre as malformações congênitas graves, afetando de duas a três crianças por 100 nascidos vivos, sendo o defeito do septo atrioventricular (DSAV) responsável por 5% desses, e atingindo cerca de 50% dos pacientes portadores de Síndrome de Down. Caracteriza-se essencialmente por vários graus de desenvolvimento incompleto do tecido septal ao redor das valvas atrioventriculares, bem como de anormalidades na formação das mesmas. Recomenda-se a correção cirúrgica ao redor de 4 meses de vida, no intuito de prevenir o surgimento de hipertensão pulmonar (HP) irreversível devida ao hiperfluxo pulmonar, no entanto a despeito disso, identifica-se a presença de hipertensão pulmonar em pacientes já submetido ä correção do defeito cardíaco. O presente estudo teve por objetivo analisar a prevalência de hipertensão pulmonar diagnosticada através do ecocardiografia e identificar dos fatores de risco em pacientes submetidos à correção cirúrgica de DSAV nos últimos 16 anos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão preto da Universidade de São Paulo (HCFMRP - USP). Foram selecionados pacientes portadores de DSAV, submetidos à correção cirúrgica no HCFMRP - USP, no período de janeiro de 1999 a janeiro de 2016, em seguimento no Ambulatório de Cardiologia Infantil do HCFMRP-USP, considerados portadores de hipertensão pulmonar os pacientes que apresentaram à ecocardiografia valores estimados de pressão sistólica de artéria pulmonar (PSAP) superiores a 30 mmHg. Foram analisadas variáveis clínicas pré e pós-operatórias. Não foi encontrada correlação entre peso e idade na data da correção cirúrgica e presença de HP na avaliação ecocardiográfica pós-operatória; no entanto esta se relacionou com tempo prolongado de circulação extra-corpórea e ventilação mecânica. Houve aumento significativo na sobrevida nos últimos oito anos analisados, refletindo a melhoria na qualidade de atendimento clinico e cirúrgico dos pacientes. A alta perda de seguimento ambulatorial causa preocupação, porém reflete as dificuldades próprias de serviços de saúde de países em desenvolvimento.
Congenital heart diseases are the most common serious congenital malformations, affecting two of three children per 100 newborns, the atrioventricular septal defect (AVSD) is responsible for 5% of these cases, reaching almost 50% of bearers of Down\'s Syndrome. It has been characterized essentially by many incomplete development degrees of de septal tissue around the atrioventricular valves, as well as its formation abnormalities. The actual recommendation is to proceed surgical correction nearly 4 months of age, in order to prevent irreversible pulmonary hypertension (PH) due to the pulmonary overflow. Despite of the surgical correction, patients may present pulmonary hypertension. This research aimed to analyze the prevalence of pulmonary hypertension diagnosed by transthoracic echocardiogram and identify risk factors for this outcome in patients undergoing surgical correction of AVSD in the last 16 years at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP - USP). All patients diagnosed with AVSD, submitted to surgical correction and followed at the HCFMRP - USP in the last 16 years and were selected. Those who had systolic pulmonary arterial pressure above 30 mmHg in the echocardiogram evaluation were considered to have pulmonary hypertension. Clinical variables before and after surgery were analyzed. Anthropometric and age data at the surgery had no influence in the presence of PH in the follow up. Although prolonged cardiopulmonary bypass and pulmonary mechanical ventilation had significantly affected that outcome. The survival had increased significantly in the last eight years of our study, reflecting the improvement of assistance. A high loss of follow up was detected and made us very concerned, however shows the difficulties and low investment in the public health system in developing countries.
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Ewert, Peter. "Interventioneller Verschluss von Vorhofdefekten." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2003. http://dx.doi.org/10.18452/13877.

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Einleitung Der interventionelle Verschluß eines einfachen Vorhofseptumdefekts (ASD) vom Sekundumtyp und eines persistierenden Foramen ovale (PFO) ist zur Routinemethode gereift (1). Die Intervention wird unter Röntgendurchleuchtung (Strahlenexposition) durchgeführt. Sie ist wegen der geringen Invasivität auch bis ins hohe Alter mit deutlich niedrigerem Risiko als eine Operation durchführbar (2). Die hier vorgestellten Arbeiten haben systematisch untersucht, welche Möglichkeiten bestehen, bei der Intervention auf eine Strahlenexposition zu verzichten (3-6), welche interventionellen Möglichkeiten bei multiplen Defekten und Vorhofseptumaneurysmen bestehen (7,8) und welche Auswirkungen ein restriktiver linker Ventrikel auf die hämodynamische Adaptation nach Defektverschluß haben kann (9-11). Methodik Alle Untersuchungen wurden im Rahmen der klinischen Routine im Herzkatheterlabor am sedierten Patienten mit Vorhofseptumdefekt vom Sekundumtyp, persistierendem Foramen ovale, perforiertem Vorhofseptumaneurysma oder multiperforiertem Vorhofseptum durchgeführt. 1. Es wurde eine Methode zum Verschluß von Vorhofseptumdefekten unter alleiniger Ultraschallkontrolle entwickelt, d.h. unter vollständigem Verzicht auf die sonst notwendige Röntgenstrahlung. 2. Die Morphologie von Vorhofseptumaneurysmen und multiperforierten Vorhofsepten wurde analysiert und im Hinblick auf die interventionellen Verschlußmöglichkeiten klassifiziert. Dabei wurde auch die Möglichkeit der simultanen Implantation mehrerer Okkluder mit einbezogen. 3. Zur Erkennung von Patienten mit einem restriktiven linken Ventrikel, der unmittelbar nach ASD-Verschluß insuffizient werden könnte, wurde eine Methode der präinterventionellen hämodynamischen Evaluation etabliert. Dazu wird die Vorlast und die diastolische Funktion des linken Ventrikels unter temporärem Verschluß des ASD mit einem Okklusionsballon untersucht. Demaskiert sich eine linksventrikuläre Restriktion, so wird als Therapiekonzept der Ventrikel auf den interventionellen Verschluß durch eine prophylaktische 'Konditionierung' mittels Diuretika und Inotropika vorbereitet. Resultate 1. Interventioneller ASD-Verschluß ohne Strahlenexposition Wir konnten zeigen, daß der interventionelle ASD-Verschluß ohne Einsatz von Röntgenstrahlung durchführbar ist (3). Dies gilt für die präinterventionelle Diagnostik, die invasive Größenmessung (Ballonsizing) (6) und den interventionelle Verschluß selbst (4). Als einziges bildgebendes Verfahren für die Intervention dient die Echokardiographie. Im Vergleich zum Standardprocedere waren beim Verzicht auf eine Strahlenexposition gleich gute Ergebnisse zu erzielen, die Prozedurdauer war vergleichbar. Beim spontan atmenden Patienten sind für diese Methode höhere Dosen an Sedierung erforderlich, um die längere Verweilzeit der transösophagealen Echokardiographiesonde zu ermöglichen (5). Der Amplatzer Occluder ist wegen seiner guten Sichtbarkeit im transösophagealen Ultraschall, seiner Rotationssymmetrie und seiner einfachen Plazierung für diese neue Methode des ASD-Verschlusses ohne Röntgenstrahlung besonders geeignet. 2. Verschluß morphologisch komplexer Vorhofseptumdefekte Auch multiperforierte Vorhofsepten können interventionell erfolgreich verschlossen werden. Bei dicht nebeneinander liegenden Defekten ist dies mit einem Occluder, der alle Defekte abdeckt, möglich, bei weiter auseinanderliegenden Defekten ist die simultane Implantation zweier Occluder sinnvoll. Zwei Occluder führen mit größerer Sicherheit zu einem Verschluß ohne Restshunt (7). Multiple Defekte sind häufig mit einem Vorhofseptumaneurysma vergesellschaftet. Im Hinblick auf die Interventionsmöglichkeiten läßt sich diese Anomalie in vier Gruppen unterteilen: Aneurysma mit PFO (Typ A), mit ASD (Typ B), mit mehreren dicht nebeneinander liegenden Defekten (Typ C) und große Aneurysmen mit einer Vielzahl irregulär verteilter Perforationen (Typ D). Die ersten drei Formen lassen sich interventionell verschließen. Dabei gelingt zumindest eine Teilstabilisierung der Aneurysmen (8). 3. Vorhofseptumdefekte und restriktiver linker Ventrikel Wir konnten zeigen, daß insbesondere bei älteren Patienten mit ASD eine verdeckte linksventrikuläre Restriktion vorliegen kann. Ein interventioneller ASD-Verschluß kann bei diesen Patienten zur akuten kardialen Dekompensation führen (9). Als Hinweis auf eine gestörte linksventrikuläre Compliance fanden wir bei temporärer Okklusion des Defekts einen deutlichen Anstieg des linksatrialen Drucks und einen gestörten Mitralklappeneinstrom (10). Nach einer prophylaktischen 'Konditionierung' des linken Ventrikels mittels vorlastsenkenden und inotropiesteigernden Medikamenten (Diuretika, Phosphodiesterasehemmer, Katecholamine) gelang bei fast allen Patienten der interventionelle ASD-Verschluß mit guter Adaptation des Ventrikels, ohne daß es zur kardialen Dekompensation kam (11). Schlußfolgerungen Die in dieser Habilitationsschrift ausgeführten Arbeiten haben weiterführende Fragestellungen und Grenzbereiche des interventionellen Verschlusses von ASD und PFO aufgezeigt und neue interventionelle Therapiestrategien dargestellt. Dadurch ist es möglich, im klinischen Alltag weniger Röntgenstrahlung und Röntgenkontrastmittel zu verwenden, auch morphologisch komplexe Defekte standardisiert zu behandeln und selbst im hohen Alter bei Vorliegen einer linksventrikulären restriktiven Dysfunktion Defekte mit geringem Risiko zu verschließen.
Introduction Interventional closure of the simple secundum type atrial septal defect (ASD) and of persistent foramen ovale (PFO) has developed into a routine procedure (1). The intervention is carried out under X-ray monitoring (X-ray exposure). Since it is minimally invasive it can be carried out even in patients of advanced age with significantly less risk than an operation (2). The work presented here investigates systematically the possibilities of carrying out the intervention without X-ray exposure (3-6) and in the case of multiple defects and atrial aneurysms (7, 8). It also looks at the effects of a restrictive left ventricle on hemodynamic adaptation after closure of the defect (9-11). Methods All examinations were carried out as part of the clinical routine of the heart catheter laboratory in sedated patients with a secundum type atrial septal defect, persistent foramen ovale, perforated atrial aneurysms or multiply perforated atrial septum. 1. A method was developed whereby the closure of atrial septal defects can be carried out solely under echocardiographic monitoring, i.e. completely without X-ray exposure. 2. The morphology of atrial septal aneurysms and multiply perforated atrial septum was analyzed and classified with regard to the possibilities of interventional closure. The possibility of simultaneous implantation of several occluders was also considered. 3. To recognize patients with a restrictive left ventricle, which might become insufficient directly after ASD closure, a method of preinterventional hemodynamic evaluation was established. This involves examining preload and the diastolic function of the left ventricle during temporary closure of the ASD with an occlusion balloon. If this procedure reveals left ventricular restriction, the ventricle is prepared for interventional closure by prophylactic conditioning by means of diuretics and inotropes. Results 1. Interventional ASD Closure without X-Ray Exposure We were able to show that interventional ASD closure is possible without the use of X-rays (3). This applies to the preinterventional diagnostic procedures, invasive size measurement (balloon sizing) (6) and the interventional closure itself (4). The sole imaging procedure used for the intervention is echocardiography. In comparison with the standard procedure, the results are equally good and the duration of the procedure is comparable. In the spontaneously breathing patient higher sedative doses are necessary so that the transesophageal echocardiography tube can remain in place throughout (5). The Amplatzer occluder is particularly suitable for this new method because it is easily viewed in transesophageal echocardiographic imaging, rotationally symmetrical and easily positioned. 2. Closure of Morphologically Complex Atrial Septal Defects Multiple perforations of the atrial septum can also be successfully closed by intervention. If the defects are close together, one occluder can be used to cover all the defects; if they are further apart, the simultaneous implantation of two occluders is indicated. Two occluders are more likely to achieve occlusion without residual shunt (7). Multiple defects are often associated with an atrial septal aneurysm. With regard to the interventional possibilities these anomalies can be divided into four groups: aneurysm with PFO (type A), with ASD (type B), with several defects situated close together (type C) and large aneurysms with a number of irregularly distributed perforations (type D). The first three types may be closed by intervention, which mostly achieves partial stabilization of the aneurysms (8). 3. Atrial Septal Defects and Restrictive Left Ventricle We showed that, in particular in older patients with ASD, left ventricular restriction may be concealed. In these patients interventional ASD closure can lead to acute cardiac decompensation (9). A sign of disruption of left ventricular compliance was a marked rise in the left atrial pressure and disturbance of the mitral valve inflow during temporary occlusion of the defect (10). Following prophylactic 'conditioning' of the left ventricle by drugs that reduce the preload and increase inotropism (diuretics, phosphodiesterase inhibitors, catecholamines), interventional ASD closure succeeded in almost all patients with good adaptation of the ventricle and without cardiac decompensation occurring (11). Conclusion The work reported here addresses complex questions and frontier areas of the interventional closure of ASDs and PFO and presents new interventional strategies. It enables less X-ray exposure and less X-ray contrast medium to be used in clinical practice. Morphologically complex defects can be treated by standard procedures and with a small risk, even in patients with advanced age and left ventricular restrictive dysfunction.
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Books on the topic "Atrial septal defects"

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Lewis, Wendy A. Sabrina: The girl with a hole in her heart : based on a true story of hope and big hearts. Valencia, CA: Two Dolphins Pub. Group, 2011.

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Katritsis, Demosthenes G., Bernard J. Gersh, and A. John Camm. Atrial septal defects. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199685288.003.0076_update_004.

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Secundum atrial septal defects, such as ostium secundum defect, sinus venosus defect, and patent foramen ovale, are discussed. Indications of closure and the recommendations of ACC/AHA and ESC are presented.
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Pillai, Ajith Ananthakrishna, and Vidhyakar Balasubramanian, eds. Atrial Septal Defects. CRC Press, 2021. http://dx.doi.org/10.1201/9781003099550.

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Thorne, Sara, and Paul Clift, eds. Atrial septal defects (ASDs). Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199228188.003.0013.

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Introduction 94Ostium secundum ASD 96Ostium primum ASD 100Sinus venosus ASD 100Coronary sinus defect 102Patent foramen ovale 104Interatrial communications account for ~10% of congenital heart disease. Different types of atrial septal defect (ASD) are illustrated in Fig. 8.1.•...
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Nguyen, Khoa, and Patrick Callahan. Transcatheter Closure of Atrial Septal Defects. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0014.

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The term congenital heart disease encompasses a vast array of lesions that present unique anesthetic challenges. Making up close to 10% of all congenital heart disease, atrial septal defects are some of the more commonly encountered congenital lesions. Atrial chambers in the heart are separated by a septum that forms during embryological development. When the septum does not develop normally, blood communicates between the right and left atria. This alteration in flow has significant effects on both cardiac and pulmonary anatomy and physiology. Cardiothoracic surgery used to be the only way to close defects that did not spontaneously close. Transcatheeter device closure of atrial septal defects in the cardiac catheterization lab has become increasingly common and offers significant advantages over open heart surgery. This chapter highlights the anatomic and physiologic considerations of the different types of atrial septal defects and discusses the details of transcatheter closure including indications, timing, and risks.
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Thorne, Sara, and Sarah Bowater. Septal defects. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198759959.003.0009.

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This chapter explores atrial septal defects (ASDs), including ostium secundum ASD, ostium primum ASD, sinus venosus ASD, coronary sinus defect, and patent foramen ovale. Ventricular septal defects (VSDs) are also discussed, including definition and incidence, cardiac associations, presentation, physical signs, investigation, and management. A further section explores atrioventricular septal defects (AVSDs), including associations, incidence and recurrence, clinical presentation, investigation, surgical management, and late complications after repair AVSD repair.
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Thorne, Sara, and Paul Clift, eds. Atrioventricular septal defects (AVSDs). Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199228188.003.0015.

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Definition 110Associations 110Incidence and recurrence 110Clinical presentation 112Investigation 112Surgical management 112Late complications post repair of AVSD 112• Key feature = common atrioventricular (AV) junction and AV valve ring.• The atrial component of an AVSD = ostium primum ASD....
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Archer, Nick, and Nicky Manning. Septal anomalies. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199230709.003.0009.

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Atrial septal defects 122Ventricular septal defects 124Atrioventricular septal defects 134• The presence of a patent foramen ovale (PFO) is essential for right-to-left flow of oxygenated blood returning from the placenta to reach vital organs.• Distinguishing between PFO and an ASD is difficult and the diagnosis can only be made with certainty if the atrial septum is virtually absent. It is suggested that if the size of the gap in the atrial septum is greater than the diameter of the AA then the possibility of a significant ASD postnatally should be considered....
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Alapati, Srilatha. Historical Aspects of Transcatheter Occlusion of Atrial Septal Defects. INTECH Open Access Publisher, 2012.

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Archer, Nick, and Nicky Manning. Septal anomalies. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198766520.003.0012.

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This chapter explores septal abnormalities, including discussion on atrial septal defects (including an introduction, secundum, and sinus venosus type), ventricular septal defects (including an introduction, perimembranous, inlet, outlet, muscular, apical, and doubly committed subarterial), and atrioventricular septal defects (including an introduction, partial, complete, and intermediate).
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Book chapters on the topic "Atrial septal defects"

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Corno, Antonio F. "Atrial septal defect." In Congenital Heart Defects, 13–19. Heidelberg: Steinkopff, 2003. http://dx.doi.org/10.1007/978-3-642-57358-3_3.

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Fraser, Alan G. "Atrial Septal Defects." In The Noninvasive Evaluation of Hemodynamics in Congenital Heart Disease, 200–221. Dordrecht: Springer Netherlands, 1990. http://dx.doi.org/10.1007/978-94-009-0647-1_8.

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Goldberg, Steven P., Deborah Kozik, Lisa B. Willis, and Eduardo M. da Cruz. "Atrial Septal Defects." In Critical Care of Children with Heart Disease, 159–67. London: Springer London, 2009. http://dx.doi.org/10.1007/978-1-84882-262-7_15.

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De Simone, Raffaele. "Atrial Septal Defects." In Atlas of Transesophageal Color Doppler Echocardiography and Intraoperative Imaging, 110–19. Berlin, Heidelberg: Springer Berlin Heidelberg, 1994. http://dx.doi.org/10.1007/978-3-642-78956-4_11.

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da Cruz, Eduardo M., Steven P. Goldberg, Lisa B. Howley-Willis, and Deborah Kozik. "Atrial Septal Defects." In Critical Care of Children with Heart Disease, 155–63. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-21870-6_14.

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Harlan, Bradley J., Albert Starr, and Fredric M. Harwin. "Atrial Septal Defects." In Illustrated Handbook of Cardiac Surgery, 218–29. New York, NY: Springer New York, 1996. http://dx.doi.org/10.1007/978-1-4612-2324-5_18.

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Harlan, Bradley J., Albert Starr, Fredic M. Harwin, and Alain Carpentier. "Atrial Septal Defects." In Manual of Cardiac Surgery, 267–79. New York, NY: Springer New York, 1995. http://dx.doi.org/10.1007/978-1-4612-2474-7_19.

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McConnell, Michael E., and Alan Branigan. "Atrial Septal Defects." In Pediatric Heart Sounds, 27–37. London: Springer London, 2008. http://dx.doi.org/10.1007/978-1-84628-684-1_3.

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Naimi, Iman, and Jason F. Deen. "Atrial Septal Defects." In Cardiac Surgery, 839–47. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-24174-2_92.

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Hofbeck, Michael, Karl-Heinz Deeg, and Thomas Rupprecht. "Atrial Septal Defects." In Doppler Echocardiography in Infancy and Childhood, 33–43. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-42919-9_2.

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Conference papers on the topic "Atrial septal defects"

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Ghiorghiu, Ioana Adriana, Cristina Ramona Radulescu, Roxana Enache, and Doina Anca Plesca. "P54 Primary versus secondary vascular disorder in two cases of medium-sized atrial septal defects." In 8th Europaediatrics Congress jointly held with, The 13th National Congress of Romanian Pediatrics Society, 7–10 June 2017, Palace of Parliament, Romania, Paediatrics building bridges across Europe. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2017. http://dx.doi.org/10.1136/archdischild-2017-313273.142.

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Hackner, D., S. Eichhorn, P. Merkle, P. Ewert, and N. Lang. "Evaluation of Different Approaches for Atrial Septal Defect Closure." In 52nd Annual Meeting of the German Society for Pediatric Cardiology. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705572.

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Hatata, A., A. Abouelnaga, and P. Nair. "G11 Isolated secundum ASD (atrial septal defect) – size matters!" In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 25 September 2020–13 November 2020. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-rcpch.3.

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Wong, Kelvin K. L., Richard M. Kelso, Stephen G. Worthley, J. Mazumdar, and Derek Abbott. "MR fluid motion tracking of blood flow in right atrium of patient with atrial septal defect." In 2008 International Conference on Technology and Applications in Biomedicine (ITAB). IEEE, 2008. http://dx.doi.org/10.1109/itab.2008.4570665.

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Wong, Kelvin K. L., P. Molaee, P. Kuklik, Richard M. Kelso, S. G. Worthley, P. Sanders, J. Mazumdar, and D. Abbott. "Motion Estimation of Vortical Blood Flow Within the Right Atrium in a Patient with Atrial Septal Defect." In 2007 IEEE/ICME International Conference on Complex Medical Engineering. IEEE, 2007. http://dx.doi.org/10.1109/iccme.2007.4381864.

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Carpenter, Alexander, Oliver Crowther, Alexander Gall, Sarah Elgamal, Richard Bennett, Mohamed Mehisen, Mark Turner, and Ashley Nisbet. "138 Natural history of atrial fibrillation and atrial fibrillation ablation in patients undergoing percutaneous atrial septal defect closure." In British Cardiovascular Society Annual Conference ‘Digital Health Revolution’ 3–5 June 2019. BMJ Publishing Group Ltd and British Cardiovascular Society, 2019. http://dx.doi.org/10.1136/heartjnl-2019-bcs.135.

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Bakoš, Matija, Filip Rubić, Dalibor Šarić, Daniel Dilber, Ivan Malčić, and Dorotea Bartoniček. "P505 Brain abscess as a first manifestation of atrial septal defect." In Faculty of Paediatrics of the Royal College of Physicians of Ireland, 9th Europaediatrics Congress, 13–15 June, Dublin, Ireland 2019. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2019. http://dx.doi.org/10.1136/archdischild-2019-epa.841.

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Sigler, M., K. Eildermann, R. Foth, and T. Paul. "Atrial Septal Defect (ASD) Occluder–Histopathology in 59 Human Explanted Devices." In 52nd Annual Meeting of the German Society for Pediatric Cardiology. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705544.

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Mefleh, Fuad N., G. Hamilton Baker, and David M. Kwartowitz. "Efficacy of a novel IGS system in atrial septal defect repair." In SPIE Medical Imaging, edited by David R. Holmes and Ziv R. Yaniv. SPIE, 2013. http://dx.doi.org/10.1117/12.2007988.

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Kwartowitz, David M., Fuad N. Mefleh, and George H. Baker. "Towards image-guided atrial septal defect repair: an ex vivo analysis." In SPIE Medical Imaging, edited by David R. Holmes III and Kenneth H. Wong. SPIE, 2012. http://dx.doi.org/10.1117/12.910689.

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Reports on the topic "Atrial septal defects"

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Huang, Weimin, Biao Hou, and Liang Wang. Safety and efficacy of robotic versus endoscopic atrial septal defect repair: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2021. http://dx.doi.org/10.37766/inplasy2021.4.0138.

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