Immediate and Short-Term Outcomes of Transcatheter VS Surgical Closure of Secundum Atrial Septal Defect in Erbil Surgical Specialty Hospital/Cardiac Center

Zahrah Jamal  Hamad; Aso Faeq  Salih; Zuhair Ibrahim  Al-Nasiry

doi:10.56056/

Authors

Zahrah Jamal Hamad MBChB, M.B.Ch.B, FKBMS (Ped), Pediatric Cardiology. Surgical Specialty Hospital-Erbil Cardiac Center-Erbil City-Kurdistan Region/Iraq.
Aso Faeq Salih M.B.Ch.B, DCH, FIBMS, FACC, MSc Pediatric Cardiology; Professor in Pediatric Cardiology; Sulaimanyah Center- Sulaimanyah City-Kurdistan Region/Iraq.
Zuhair Ibrahim Al-Nasiry M.B.Ch.B, D.M,MSc Pediatric Cardiology; Surgical Specialty Hospital-Erbil Cardiac Center-Erbil City-Kurdistan Region/Iraq.

DOI:

https://doi.org/10.56056/

Keywords:

Atrial septal defect, Echocardiogram, Transcatheter, Surgery

Abstract

Introduction: The secundum atrial septal defect is a common congenital heart disease in children and adolescents. This study set out to compare transcatheter closure versus surgical closure for secundum atrial septal defect in children and adolescents in terms of immediate and short-term results of.

Methods: A prospective interventional study conducted in Surgical Specialty hospital-Erbil cardiac center in Erbil city-Kurdistan region/Iraq in duration of twelve months 1^st of April 2023 to 31^st of March 2024 on sample of 50 children with secundum atrial septal defect divided into two study groups (25 children underwent transcatheter intervention and 25 children underwent surgical intervention). Post procedure outcomes (Heart rate, ECG changes, complications, hospital stay duration) were assessed.

Results: In both study groups, the means of vital signs were significantly reduced after 3 months from intervention (p<0.001). After 3 months, the means of heart rate and QRS duration were not significantly different between two study groups (p>0.05), while means of p wave minimum, p wave maximum, p wave dispersion and PR interval were significantly lower among children underwent transcatheter intervention (p≤0.05). There was a highly a significant association between longer hospital stay and children underwent surgical intervention (p<0.001).

Conclusion: Both transcatheter and surgical closure of secundum atrial septal defect are effective, but the transcatheter intervention is associated with less immediate complications and shorter hospital stay duration.

Downloads

Download data is not yet available.

References

1. Bradley EA, Zaidi AN. Atrial Septal Defect. Cardiol Clin 2020; 38(3):317-324.

2. Celermajer DS. Atrial septal defects: even simple congenital heart diseases can be complicated. Eur Heart J 2018; 39(12):999-1001.

3. Fraisse A, Latchman M, Sharma SR, Bayburt S, Amedro P, di Salvo G, et al. Atrial septal defect closure: indications and contra-indications. J Thorac Dis 2018; 10(Suppl 24): S2874-S2881.

4. Giang KW, Mandalenakis Z, Fedchenko M, Eriksson P, Rosengren A, Norman M, et al. Congenital heart disease: Changes in recorded birth prevalence and cardiac interventions over the past half-century in Sweden. Eur J Prev Cardiol 2023; 30(2):169–176.

5. Naqvi N, McCarthy KP, Ho SY. Anatomy of the atrial septum and interatrial communications. J Thorac Dis 2018; 10(Suppl 24): S2837–S2847.

6. Kuijpers JM, Mulder BJ, Bouma BJ. Secundum atrial septal defect in adults: A practical review and recent developments. Neth Heart J 2015; 23: 205–211.

7. Geva T, Martins JD, Wald RM. Atrial septal defects. Lancet 2014; 383: 1921–1932.

8. Torres AJ. Hemodynamic assessment of atrial septal defects. J Thorac Dis 2018; 10(Suppl 24): S2882–S2889.

9. Nyboe C, Karunanithi Z, Nielsen-Kudsk JE, Hjortdal VE. Long-term mortality in patients with atrial septal defect: A nationwide cohort-study. Eur Heart J 2018; 39(12):993–998.

10. Feltes TF, Bacha E, Beekman RH, 3rd, Cheatham JP, Feinstein JA, Gomes AS, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: A scientific statement from the American Heart Association. Circulation 2011; 123(22):2607–2652.

11. Riggs T, Sharp SE, Batton D, Hussey ME, Weinhouse E. Spontaneous closure of atrial septal defects in premature versus full-term neonates. Pediatr Cardiol 2000; 21(2):129–134.

12. Hanslik A, Pospisil U, Salzer-Muhar U, Greber-Platzer S, Male C. Predictors of spontaneous closure of isolated secundum atrial septal defect in children: A longitudinal study. Pediatrics 2006; 118(4):1560–1565.

13. Vyas-Read S, Guglani L, Shankar P, Travers C, Kanaan U. Atrial septal defects accelerate pulmonary hypertension diagnoses in premature infants. Front Pediatr 2018; 6:342.

14. Triedman JK, Newburger JW. Trends in Congenital Heart Disease: The Next Decade. Circulation 2016; 133: 2716–2733.

15. Engelings CC, Helm PC, Abdul-Khaliq H, Asfour B, Bauer UM, Baumgartner H, et al. Cause of death in adults with congenital heart disease—An analysis of the German National Register for Congenital Heart Defects. Int J Cardiol 2016; 211: 31–36.

16. Pei L, Kang Y, Zhao Y, Yan H. Prevalence and risk factors of congenital heart defects among live births: A population-based cross-sectional survey in Shaanxi province, Northwestern China. BMC Pediatr 2017; 17: 18.

17. Kuijpers JM, van der Bom T, van Riel AC, Meijboom FJ, van Dijk AP, Pieper PG, et al. Secundum atrial septal defect is associated with reduced survival in adult men. Eur Heart J 2015; 36(31):2079-2086.

18. Akagi T. Current concept of transcatheter closure of atrial septal defect in adults. J Cardiol 2015; 65(1):17-25.

19. Kutty S, Hazeem AA, Brown K, Danford CJ, Worley SE, Delaney JW, et al. Long-term (5- to 20-year) outcomes after transcatheter or surgical treatment of hemodynamically significant isolated secundum atrial septal defect. Am J Cardiol 2012; 109(9):1348-1352.

20. Ooi YK, Kelleman M, Ehrlich A, Glanville M, Porter A, Kim D, et al. Transcatheter Versus Surgical Closure of Atrial Septal Defects in Children: A Value Comparison. JACC Cardiovasc Interv 2016; 9(1):79-86.

21. Moore J, Hegde S, El-Said H, Beekman R 3rd, Benson L, Bergersen L, et al; ACC IMPACT Steering Committee. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv 2013; 6(5):433-442.

22. O'Byrne ML, Glatz AC, Gillespie MJ. Transcatheter device closure of atrial septal defects: more to think about than just closing the hole. Curr Opin Cardiol 2018; 33(1):108-116.

23. Feigenbaum H, Armstrong W, Ryan TArmstrong W. Echocardiographic assessment of the interatrial septal defect Feigenbaum’s Echocardiography. 6th ed. 2005. Philadelphia, PA Lippincott.

24. Chambault A-L, Olsen K, Brown LJ, Mellor SL, Sorathia N, Thomas AE, et al. Transcatheter versus surgical closure of atrial septal defects: a systematic review and meta-analysis of clinical outcomes. Cardiology in the Young. 2022;32(1):1–9. doi:10.1017/S1047951121004583/

25. How to measure the PR interval. My EKG. Available from: https://en.my-ekg.com/how-read-ekg/pr-interval.html/

26. Jalal Z, Hascoet S, Baruteau AE, Iriart X, Kreitmann B, Boudjemline Y, et al. Long-term Complications after Transcatheter Atrial Septal Defect Closure: A Review of the Medical Literature. Can J Cardiol 2016; 32(11): 1315.e11-1315.e18.

27. Talwar S, Patel K, Juneja R, Choudhary SK, Airan B. Early postoperative arrhythmias after pediatric cardiac surgery. Asian Cardiovascular and Thoracic Annals 2015; 23(7):795-801.

28. Mansour NM, Ghonimy El Sheikh R, Elsaeid AM, El-setiha ME, Badr SF. Factors determining occurrence of arrhythmias in patients postclosure of atrial septal defects. J Saudi Heart Assoc. 2021; 33 (3):221-227. Available from: https://doi.org/10.37616/2212-5043.1260/

29. 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(11):1836-1844.

30. Siddiqui WT, Usman T, Atiq M, Amanullah MM. Transcatheter versus surgical closure of atrial septum defect: a debate from a developing country. J Cardiovasc Thorac Res 2014; 6(4):205-210.

31. Saleem S, Younas M, Asma T, Riaz U, Tousif R, Maqbool B. Comparison of Short-Term Outcomes of Transcatheter versus Surgical Closure of Atrial Septum Defect at a Tertiary Cardiac Care Facility. PAFMJ 2023; 73(3): 837–40. Available from: https://doi.org/10.51253/pafmj.v73i3.8633/

32. Askari B, Soraya H, Ayremlu N, Golmohammadi M. Short-term outcomes after surgical versus trans catheter closure of atrial septal defects; a study from Iran. Egypt Heart J 2018; 70(4):249-253.

33. Bartakian S, Fagan TE, Schaffer MS, Darst JR. Device closure of secundum atrial septal defects in children <15 kg: complication rates and indications for referral. JACC Cardiovasc Interv 2012; 5(11):1178-1184.

34. Kodaira M, Kawamura A, Okamoto K, Kanazawa H, Minakata Y, Murata M, et al. Comparison of Clinical Outcomes After Transcatheter vs. Minimally Invasive Cardiac Surgery Closure for Atrial Septal Defect. Circ J 2017; 81(4):543-551.