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Comparison of closure of secundum atrial septal defects (ASD) under transesophageal echocardiographic (TEE) guidance though right anterolateral minithoracotomy versus percutaneus approaches
Received:May 05, 2020  Revised:May 19, 2020  Click here to download the full text
Citation of this paper:SHEN Jin-qiang,WEI Lai,JI Qiang,SUN Yong-xin,ZHAO Dong,DONG Li-li,LIU Chen,WANG Chun-sheng.Comparison of closure of secundum atrial septal defects (ASD) under transesophageal echocardiographic (TEE) guidance though right anterolateral minithoracotomy versus percutaneus approaches[J].Chinese Journal of Clinical Medicine,2020,27(3):397-400
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Author NameAffiliationE-mail
SHEN Jin-qiang Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
WEI Lai Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
JI Qiang Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
SUN Yong-xin Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
ZHAO Dong Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
DONG Li-li Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
LIU Chen Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China liu.chen@zs-hospital.sh.cn 
WANG Chun-sheng Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China  
Abstract:Objective: To compare the results of closure of secundum atrial septal defects (ASD) under transesophageal echocardiographic (TEE) guidance though right anterolateral minithoracotomy versus percutaneus approaches.Methods: Clinical data of 310 patients undergoing isolated closure of secundum ASD under TEE guidance between February 2008 and April 2020 at the Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University were retrospectively analyzed. There were 80 male and 230 female patients, aging from 2 to 76 years with a mean age of (40±14) years. Of these, 198 patients received percutaneous intervention (PI group) and 112 patients received right anterolateral minithoracotomy (RT group). Outcomes of the two groups were compared using t test and χ2 test.Results: There were no in-hospital deaths in both groups. The operation was successfully completely in 189 patients in the PI group and 108 patients in the RT group (95.5% vs 96.4%), and the occluder dislocation occurred in 3 patients in the PI group and 2 patients in the RT group (2.7% vs 1.0%), there was no significant difference between the two groups. Patients in the PI group was associated with a higher rate of endotracheal intubation removal in the operating room (76.8% vs 7.1%). Patients in the PI group had a shorter hospital stay ([2.1±0.9] d vs[3.8±1.6] d) and a lower rate of postoperative complications (0 vs 5.4%), these differences were statistically significant (P<0.05).Conclusions: Closure of secundum ASD under TEE guidance via RT and PI are both safe and feasible without deaths. The PI has less trauma, shorter postoperative hospital stay and faster recovery. For ASD patients with a suitable anatomy, percutaneous closure can be considered as the first therapeutic option.
keywords:closure of secundum atrial septal defects  transesophageal echocardiographic  right anterolateral minithoracotomy  percutaneous intervention
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