Abstract:
OBJECTIVES:This study sought to compare the safety, efficacy and clinical utility of the Amplatzer septal occluder (ASO) for closure of secundum atrial septal defect (ASD) with surgical closure. BACKGROUND:The clinical utility of a device such as the ASO can only be judged against the results of contemporaneous surgery. METHODS:A multicenter, nonrandomized concurrent study was performed in 29 pediatric cardiology centers from March 1998 to March 2000. The patients were assigned to either the device or surgical closure group according to the patients' option. Baseline physical exams and echocardiography were performed preprocedure and at follow-up (6 and 12 months for device group, 12 months for surgical group). RESULTS:A total of 442 patients were in the group undergoing device closure, whereas 154 patients were in the surgical group. The median age was 9.8 years for the device group and 4.1 years for the surgical group (p < 0.001). In the device group, 395 (89.4%) patients had a single ASD; in the surgical group, 124 (80.5%) (p = 0.008) had a single ASD. The size of the primary ASD was 13.3 +/- 5.4 mm for the device group and 14.2 +/- 6.3 mm for the surgery group (p = 0.099). The procedural attempt success rate was 95.7% for the device group and 100% for the surgical group (p = 0.006). CONCLUSIONS:The early, primary and secondary efficacy success rates were 94.8%, 98.5% and 91.6%, respectively, for the device group, and 96.1%, 100% and 89.0% for the surgical group (all p > 0.05). The complication rate was 7.2% for the device group and 24.0% for the surgical group (p < 0.001). The mean length of hospital stay was 1.0 +/- 0.3 day for the device group and 3.4 +/- 1.2 days for the surgical group (p < 0.001). Mortality was 0% for both groups. The early, primary and secondary efficacy success rates for surgical versus. device closure of ASD were not statistically different; however, the complication rate was lower and the length of hospital stay was shorter for device closure than for surgical repair. Appropriate patient selection is an important factor for successful device closure. Transcatheter closure of secundum ASD using the ASO is a safe and effective alternative to surgical repair.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Du ZD,Hijazi ZM,Kleinman CS,Silverman NH,Larntz K,Amplatzer Investigators.doi
10.1016/s0735-1097(02)01862-4subject
Has Abstractpub_date
2002-06-05 00:00:00pages
1836-44issue
11eissn
0735-1097issn
1558-3597pii
S0735109702018624journal_volume
39pub_type
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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abstract::In adults with hypertrophic cardiomyopathy, the annual mortality rate from sudden death is 2 to 3%, and the finding of nonsustained ventricular tachycardia during electrocardiographic (ECG) monitoring provides a marker of the patient who is at increased risk. In the young, the annual mortality rate from sudden death i...
journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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更新日期:2011-09-20 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2008-04-15 00:00:00
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更新日期:2015-03-10 00:00:00
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更新日期:2016-10-18 00:00:00
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更新日期:2002-01-02 00:00:00