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Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Heart Surgery | Case report

Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report

Authors: Xicheng Deng, Taoyue Yao, Yefeng Wang, Guangxian Yang, Wenjuan Chen, Peng Huang, Zhi Chen

Published in: BMC Cardiovascular Disorders | Issue 1/2020

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Abstract

Background

There are few reports in the literature of device closure of residual shunts following initial surgical closure of an atrial septal defect (ASD). This case study reports one such case. We describe here a case of secundum type ASD that was initially closed surgically, followed by device closure of a residual shunt with a posteroinferior deficient rim.

Case presentation

A 7-month-old boy was admitted to our hospital for elective surgery to surgically correct a secundum type ASD. Unfortunately, a residual shunt 3.5 mm in diameter appeared before discharge and was enlarged at1-year follow-up. The cause of this residual shunt was dehiscence at the posteroinferior aspect, and the posteroinferior rim was 3.7 mm. After careful discussion and preparation, we proceeded with an interventional procedure. A 16 mm ASD occluder (AGA Medical Corp, Plymouth, Minnesota) was deployed successfully with no residual shunt. In some cases of ASD, interventional therapy is not considered due to the size and position of the defect, but we show here, a successful case of interventional therapy for a residual shunt with a deficient rim.

Conclusion

We have presented a case in which a postoperative residual shunt with a deficient rim was successfully closed with interventional therapy.
Literature
1.
go back to reference Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39(12):1890–900.CrossRef Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39(12):1890–900.CrossRef
2.
go back to reference Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, Del Nido P, Fasules JW, Graham TP Jr, Hijazi ZM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(23):e143–263.CrossRef Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, Del Nido P, Fasules JW, Graham TP Jr, Hijazi ZM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(23):e143–263.CrossRef
3.
go back to reference Opotowsky AR, Landzberg MJ, Kimmel SE, Webb GD. Trends in the use of percutaneous closure of patent foramen ovale and atrial septal defect in adults, 1998-2004. JAMA. 2008;299(5):521–2.CrossRef Opotowsky AR, Landzberg MJ, Kimmel SE, Webb GD. Trends in the use of percutaneous closure of patent foramen ovale and atrial septal defect in adults, 1998-2004. JAMA. 2008;299(5):521–2.CrossRef
4.
go back to reference Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, et al. ESC guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J. 2010;31(23):2915–57.CrossRef Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, et al. ESC guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J. 2010;31(23):2915–57.CrossRef
5.
go back to reference Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K, Amplatzer I. 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):1836–44.CrossRef Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K, Amplatzer I. 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):1836–44.CrossRef
6.
go back to reference Cowley CG, Lloyd TR, Bove EL, Gaffney D, Dietrich M, Rocchini AP. Comparison of results of closure of secundum atrial septal defect by surgery versus Amplatzer septal occluder. Am J Cardiol. 2001;88(5):589–91.CrossRef Cowley CG, Lloyd TR, Bove EL, Gaffney D, Dietrich M, Rocchini AP. Comparison of results of closure of secundum atrial septal defect by surgery versus Amplatzer septal occluder. Am J Cardiol. 2001;88(5):589–91.CrossRef
7.
go back to reference Ghaderian M, Sabri MR, Ahmadi AR, Dehghan B, Mahdavi C, Ataei ZZ. The efficacy and safety of using amplatzer for transcatheter closure of atrial septal defect in small children with less than 10 kg. ARYA Atheroscler. 2019;15(1):27–32.PubMedPubMedCentral Ghaderian M, Sabri MR, Ahmadi AR, Dehghan B, Mahdavi C, Ataei ZZ. The efficacy and safety of using amplatzer for transcatheter closure of atrial septal defect in small children with less than 10 kg. ARYA Atheroscler. 2019;15(1):27–32.PubMedPubMedCentral
8.
go back to reference Abu-Tair T, Wiethoff CM, Kehr J, Kuroczynski W, Kampmann C. Transcatheter closure of atrial septal defects using the GORE((R)) septal occluder in children less than 10 kg of body weight. Pediatr Cardiol. 2016;37(4):778–83.CrossRef Abu-Tair T, Wiethoff CM, Kehr J, Kuroczynski W, Kampmann C. Transcatheter closure of atrial septal defects using the GORE((R)) septal occluder in children less than 10 kg of body weight. Pediatr Cardiol. 2016;37(4):778–83.CrossRef
9.
go back to reference Desnick SJ, Neal WA, Nicoloff DM, Moller JH. Residual right-to-left shunt following repair of atrial septal defect. Ann Thorac Surg. 1976;21(4):291–5.CrossRef Desnick SJ, Neal WA, Nicoloff DM, Moller JH. Residual right-to-left shunt following repair of atrial septal defect. Ann Thorac Surg. 1976;21(4):291–5.CrossRef
10.
go back to reference Aguiar Rosa S, Ferreira F, de Sousa L, Fiarresga A, Martins JD, Galrinho A, Agapito A, Fazendas P, Pinto FF, Ferreira RC. Successful percutaneous closure of a residual atrial septal defect due to device failure. Rev Port Cardiol. 2017;36(6):475 e471–3.CrossRef Aguiar Rosa S, Ferreira F, de Sousa L, Fiarresga A, Martins JD, Galrinho A, Agapito A, Fazendas P, Pinto FF, Ferreira RC. Successful percutaneous closure of a residual atrial septal defect due to device failure. Rev Port Cardiol. 2017;36(6):475 e471–3.CrossRef
11.
go back to reference Villablanca PA, Briston DA, Rodes-Cabau J, Briceno DF, Rao G, Aljoudi M, Shah AM, Mohananey D, Gupta T, Makkiya M, et al. Treatment options for the closure of secundum atrial septal defects: a systematic review and meta-analysis. Int J Cardiol. 2017;241:149–55.CrossRef Villablanca PA, Briston DA, Rodes-Cabau J, Briceno DF, Rao G, Aljoudi M, Shah AM, Mohananey D, Gupta T, Makkiya M, et al. Treatment options for the closure of secundum atrial septal defects: a systematic review and meta-analysis. Int J Cardiol. 2017;241:149–55.CrossRef
12.
go back to reference Amedro P, Bayburt S, Assaidi A, Kreitmann B, Habib G, Fouilloux V, Fraisse A. Should transcatheter closure of atrial septal defects with inferior-posterior deficient rim still be attempted? J Thorac Dis. 2019;11(3):708–16.CrossRef Amedro P, Bayburt S, Assaidi A, Kreitmann B, Habib G, Fouilloux V, Fraisse A. Should transcatheter closure of atrial septal defects with inferior-posterior deficient rim still be attempted? J Thorac Dis. 2019;11(3):708–16.CrossRef
13.
go back to reference Kijima Y, Akagi T, Takaya Y, Taniguchi M, Nakagawa K, Kusano K, Sano S, Ito H. Deficient surrounding rims in patients undergoing transcatheter atrial septal defect closure. J Am Soc Echocardiogr. 2016;29(8):768–76.CrossRef Kijima Y, Akagi T, Takaya Y, Taniguchi M, Nakagawa K, Kusano K, Sano S, Ito H. Deficient surrounding rims in patients undergoing transcatheter atrial septal defect closure. J Am Soc Echocardiogr. 2016;29(8):768–76.CrossRef
14.
go back to reference Mulukutla V, Qureshi AM, Pignatelli R, Ing FF. Predictive factors for patients undergoing ASD device occlusion who “crossover” to surgery. Pediatr Cardiol. 2018;39(3):445–9.CrossRef Mulukutla V, Qureshi AM, Pignatelli R, Ing FF. Predictive factors for patients undergoing ASD device occlusion who “crossover” to surgery. Pediatr Cardiol. 2018;39(3):445–9.CrossRef
15.
go back to reference Murphy JG, Gersh BJ, McGoon MD, Mair DD, Porter CJ, Ilstrup DM, McGoon DC, Puga FJ, Kirklin JW, Danielson GK. Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 years. N Engl J Med. 1990;323(24):1645–50.CrossRef Murphy JG, Gersh BJ, McGoon MD, Mair DD, Porter CJ, Ilstrup DM, McGoon DC, Puga FJ, Kirklin JW, Danielson GK. Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 years. N Engl J Med. 1990;323(24):1645–50.CrossRef
16.
go back to reference Butera G, Carminati M, Chessa M, Youssef R, Drago M, Giamberti A, Pome G, Bossone E, Frigiola A. Percutaneous versus surgical closure of secundum atrial septal defect: comparison of early results and complications. Am Heart J. 2006;151(1):228–34.CrossRef Butera G, Carminati M, Chessa M, Youssef R, Drago M, Giamberti A, Pome G, Bossone E, Frigiola A. Percutaneous versus surgical closure of secundum atrial septal defect: comparison of early results and complications. Am Heart J. 2006;151(1):228–34.CrossRef
17.
go back to reference Man W, Xinxin M, Yueli Z, Feng L. Percutaneous closure of residual shunting in a patient with a fenestrated atrial septal defect occluder: a case report. Medicine (Baltimore). 2018;97(31):e11612.CrossRef Man W, Xinxin M, Yueli Z, Feng L. Percutaneous closure of residual shunting in a patient with a fenestrated atrial septal defect occluder: a case report. Medicine (Baltimore). 2018;97(31):e11612.CrossRef
18.
go back to reference Lopez AL, Palomas JL, Rubio DM, Ortiz MR. Three-dimensional echocardiography-guided repair of residual shunt after percutaneous atrial septal defect closure. Echocardiography. 2011;28(3):E64–7.CrossRef Lopez AL, Palomas JL, Rubio DM, Ortiz MR. Three-dimensional echocardiography-guided repair of residual shunt after percutaneous atrial septal defect closure. Echocardiography. 2011;28(3):E64–7.CrossRef
19.
go back to reference Berdat PA, Chatterjee T, Pfammatter JP, Windecker S, Meier B, Carrel T. Surgical management of complications after transcatheter closure of an atrial septal defect or patent foramen ovale. J Thorac Cardiovasc Surg. 2000;120(6):1034–9.CrossRef Berdat PA, Chatterjee T, Pfammatter JP, Windecker S, Meier B, Carrel T. Surgical management of complications after transcatheter closure of an atrial septal defect or patent foramen ovale. J Thorac Cardiovasc Surg. 2000;120(6):1034–9.CrossRef
20.
go back to reference Demir B, Tureli HO, Kutlu G, Karakaya O. Percutaneous closure of a postoperative residual atrial septal defect with the Occlutech Figulla Occluder device. Turk Kardiyol Dern Ars. 2012;40(1):55–8.CrossRef Demir B, Tureli HO, Kutlu G, Karakaya O. Percutaneous closure of a postoperative residual atrial septal defect with the Occlutech Figulla Occluder device. Turk Kardiyol Dern Ars. 2012;40(1):55–8.CrossRef
21.
go back to reference Chessa M, Butera G, Giamberti A, Bini RM, Carminati M. Transcatheter closure of residual atrial septal defects after surgical closure. J Interv Cardiol. 2002;15(3):187–9.CrossRef Chessa M, Butera G, Giamberti A, Bini RM, Carminati M. Transcatheter closure of residual atrial septal defects after surgical closure. J Interv Cardiol. 2002;15(3):187–9.CrossRef
22.
go back to reference Cakal B, Cakal S, Arslan K, Kahveci G, Ozkan M. Dehiscence of an atrial septal defect patch: evaluation using three-dimensional transesophageal echocardiography. Herz. 2015;40(3):455–6.CrossRef Cakal B, Cakal S, Arslan K, Kahveci G, Ozkan M. Dehiscence of an atrial septal defect patch: evaluation using three-dimensional transesophageal echocardiography. Herz. 2015;40(3):455–6.CrossRef
23.
go back to reference Sivakumar K, Singhi A, Mohanraj A, Ezhilan J. Tumor embolism from a right atrial myxoma leads to acute right heart failure after surgery and atrial septal patch dehiscence. J Am Coll Cardiol. 2014;63(23):2579.CrossRef Sivakumar K, Singhi A, Mohanraj A, Ezhilan J. Tumor embolism from a right atrial myxoma leads to acute right heart failure after surgery and atrial septal patch dehiscence. J Am Coll Cardiol. 2014;63(23):2579.CrossRef
24.
go back to reference Jang JY, Heo R, Cho MS, Bae J, Hong JA, Lee S, Ahn JM, Park DW, Kim DH, Kang DH, et al. Efficacy of 3D transoesophageal echocardiography for transcatheter device closure of atrial septal defect without balloon sizing. Eur Heart J Cardiovasc Imaging. 2018;19(6):684–9.CrossRef Jang JY, Heo R, Cho MS, Bae J, Hong JA, Lee S, Ahn JM, Park DW, Kim DH, Kang DH, et al. Efficacy of 3D transoesophageal echocardiography for transcatheter device closure of atrial septal defect without balloon sizing. Eur Heart J Cardiovasc Imaging. 2018;19(6):684–9.CrossRef
25.
go back to reference Boon I, Vertongen K, Paelinck BP, Demulier L, Van Berendoncks A, De Maeyer C, Marchau F, Panzer J, Vandekerckhove K, De Wolf D. How to size ASDs for percutaneous closure. Pediatr Cardiol. 2018;39(1):168–75.CrossRef Boon I, Vertongen K, Paelinck BP, Demulier L, Van Berendoncks A, De Maeyer C, Marchau F, Panzer J, Vandekerckhove K, De Wolf D. How to size ASDs for percutaneous closure. Pediatr Cardiol. 2018;39(1):168–75.CrossRef
26.
go back to reference Ojala T, Rosenthal E, Nugent K, Qureshi S, Simpson J. Live 3D echocardiography to guide closure of residual ASD. J Am Coll Cardiol Img. 2013;6(4):523–5.CrossRef Ojala T, Rosenthal E, Nugent K, Qureshi S, Simpson J. Live 3D echocardiography to guide closure of residual ASD. J Am Coll Cardiol Img. 2013;6(4):523–5.CrossRef
27.
go back to reference Orvalho JS. Real-time three-dimensional echocardiography: from diagnosis to intervention. Pediatr Cardiol. 2017;47(5):1005–19. Orvalho JS. Real-time three-dimensional echocardiography: from diagnosis to intervention. Pediatr Cardiol. 2017;47(5):1005–19.
Metadata
Title
Transcatheter closure of a residual shunt with posteroinferior deficient rim after surgical closure of an ASD: a case report
Authors
Xicheng Deng
Taoyue Yao
Yefeng Wang
Guangxian Yang
Wenjuan Chen
Peng Huang
Zhi Chen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01624-9

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