Comparison of clinical outcomes after transcatheter vs. Minimally invasive cardiac surgery closure for atrial septal defect

Masaki Kodaira, Akio Kawamura, Kazuma Okamoto, Hideaki Kanazawa, Yugo Minakata, Mitsushige Murata, Hideyuki Shimizu, Keiichi Fukuda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Percutaneous closure has replaced surgery for the majority of cases of secundum atrial septal defect (ASD). However, technological advances have made contemporary minimally invasive cardiac surgery (MICS) less invasive than conventional surgery. The aim of this study was to compare clinical outcomes of percutaneous closure of secundum ASD with those of contemporary MICS. Methods and Results: We conducted a single-center retrospective study of 354 patients with ASD treated either with the Amplatzer Septal Occluder (134 patients) or MICS (220 patients) between 2000 and 2013. Success rates and the incidence of complications were compared. The success rates were 98% for percutaneous closure and 100% for MICS. There were no deaths in either group. Major complications occurred in 2 patients (1.5%) who underwent percutaneous closure and in 8 patients (3.6%) treated with MICS (P=0.16). Minor complications occurred in 15 patients (11.2%) who underwent percutaneous closure and in 46 patients (20.9%) treated with MICS (P=0.02). On multivariate analysis, MICS (odds ratio [OR]: 2.91, 95% confidence interval [CI]: 1.46–5.81; P=0.002) and age >70 years (OR: 3.50, 95% CI: 1.40–8.75; P=0.008) were independent predictors of complications. Conclusions: Percutaneous closure and MICS had high success rates without deaths. For ASD patients with a suitable anatomy, percutaneous closure can be considered as the first therapeutic option.

Original languageEnglish
Pages (from-to)543-551
Number of pages9
JournalCirculation Journal
Volume81
Issue number4
DOIs
Publication statusPublished - 2017

Fingerprint

Minimally Invasive Surgical Procedures
Atrial Heart Septal Defects
Thoracic Surgery
Odds Ratio
Septal Occluder Device
Confidence Intervals
Anatomy
Multivariate Analysis
Retrospective Studies
Mortality
Incidence

Keywords

  • Congenital heart disease
  • Heart septal defect
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of clinical outcomes after transcatheter vs. Minimally invasive cardiac surgery closure for atrial septal defect. / Kodaira, Masaki; Kawamura, Akio; Okamoto, Kazuma; Kanazawa, Hideaki; Minakata, Yugo; Murata, Mitsushige; Shimizu, Hideyuki; Fukuda, Keiichi.

In: Circulation Journal, Vol. 81, No. 4, 2017, p. 543-551.

Research output: Contribution to journalArticle

Kodaira, Masaki ; Kawamura, Akio ; Okamoto, Kazuma ; Kanazawa, Hideaki ; Minakata, Yugo ; Murata, Mitsushige ; Shimizu, Hideyuki ; Fukuda, Keiichi. / Comparison of clinical outcomes after transcatheter vs. Minimally invasive cardiac surgery closure for atrial septal defect. In: Circulation Journal. 2017 ; Vol. 81, No. 4. pp. 543-551.
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N2 - Background: Percutaneous closure has replaced surgery for the majority of cases of secundum atrial septal defect (ASD). However, technological advances have made contemporary minimally invasive cardiac surgery (MICS) less invasive than conventional surgery. The aim of this study was to compare clinical outcomes of percutaneous closure of secundum ASD with those of contemporary MICS. Methods and Results: We conducted a single-center retrospective study of 354 patients with ASD treated either with the Amplatzer Septal Occluder (134 patients) or MICS (220 patients) between 2000 and 2013. Success rates and the incidence of complications were compared. The success rates were 98% for percutaneous closure and 100% for MICS. There were no deaths in either group. Major complications occurred in 2 patients (1.5%) who underwent percutaneous closure and in 8 patients (3.6%) treated with MICS (P=0.16). Minor complications occurred in 15 patients (11.2%) who underwent percutaneous closure and in 46 patients (20.9%) treated with MICS (P=0.02). On multivariate analysis, MICS (odds ratio [OR]: 2.91, 95% confidence interval [CI]: 1.46–5.81; P=0.002) and age >70 years (OR: 3.50, 95% CI: 1.40–8.75; P=0.008) were independent predictors of complications. Conclusions: Percutaneous closure and MICS had high success rates without deaths. For ASD patients with a suitable anatomy, percutaneous closure can be considered as the first therapeutic option.

AB - Background: Percutaneous closure has replaced surgery for the majority of cases of secundum atrial septal defect (ASD). However, technological advances have made contemporary minimally invasive cardiac surgery (MICS) less invasive than conventional surgery. The aim of this study was to compare clinical outcomes of percutaneous closure of secundum ASD with those of contemporary MICS. Methods and Results: We conducted a single-center retrospective study of 354 patients with ASD treated either with the Amplatzer Septal Occluder (134 patients) or MICS (220 patients) between 2000 and 2013. Success rates and the incidence of complications were compared. The success rates were 98% for percutaneous closure and 100% for MICS. There were no deaths in either group. Major complications occurred in 2 patients (1.5%) who underwent percutaneous closure and in 8 patients (3.6%) treated with MICS (P=0.16). Minor complications occurred in 15 patients (11.2%) who underwent percutaneous closure and in 46 patients (20.9%) treated with MICS (P=0.02). On multivariate analysis, MICS (odds ratio [OR]: 2.91, 95% confidence interval [CI]: 1.46–5.81; P=0.002) and age >70 years (OR: 3.50, 95% CI: 1.40–8.75; P=0.008) were independent predictors of complications. Conclusions: Percutaneous closure and MICS had high success rates without deaths. For ASD patients with a suitable anatomy, percutaneous closure can be considered as the first therapeutic option.

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