Tuesday 10 April 2018

Percutaneous Closure of Adult Atrial Septal Defects in Adults: Short- and Medium- Term Results




Atrial septal defect (ASD) is the third most common form of congenital heart defects. Controversy still exists regarding its closure in patients > 40 years-old. Few data exist on symptomatic relief and echographic parameters improvement gained after ASD closure in patients over 40 years of age. Aim: Analyze the efficacy and safety of the percutaneous closure technique in a community of adults aged over 40 years-old with (ASD) eligible for percutaneous closure. 

This is a retrospective study that included patients aged over 40 years-old who had percutaneous ASD closure between 2005 and 2013 at the cardiology department of Sahloul university hospital. Follow-up at 24 hours, 7days, 6 months, and yearly included physical examination, electrocardiogram and transthoracic echocardiography; furthermore, telephone interviews were conducted to determine clinical symptomatic status.

There were 27 patients with a mean age of 47 years (from 40 to 65); 7 were aged more than 60 years-old. There were 23 women. 24 patients had clinically significant symptoms due to their ASDs, including dyspnea (22), palpitations (10), fatigue (6), chest pain (10), and dizziness (2). 3 patients reported no symptoms prior to ASD closure. The mean size of ASD as measured by transesophageal echocardiography was 26,43mm ±6, 8 (from 12 mm to 38 mm). The mean pulmonary artery pressure (PAP) was 42, 95 mmHg ± 8, 04. The mean right ventricle diameter was 40, 6 mm ± 3, 3 (35mm, maximum = 45mm). A total of 26 patients had successful defect closure, in one patient, this could not be done due to unusual anatomy of left atrium. The Amplatzer device was used in 25 patients. The mean device size used for all patients was 27, 82 ± 6, 63 mm. There were no major complications. Symptomatic improvement was observed: 20 patients became asymptomatic. At 1year post procedure, the right ventricle diameter showed a statistically significant decrease 34 - + 6 mm (P < 0,001).

This study provided further evidence that transcatheter device closure of ASDs in adults over the age of 40 years is safe, effective, and results in symptomatic relief and regression of pulmonary pression and right ventricle size. Thus, we suggest that percutaneous closure of ASDs in adult patients greater than 40 years of age should be the first option of management.




2 comments:

  1. HELLO EVERYONE.. FEW MUNINETS TO REDY THIS INFOR ON HERPES CURE 2018..
    2017 MY MOTHER WAS DIAGNOSED OF HERPES/ KNOWN AS GENITAL WARTS ,I SPENT A LOT OF MONEY ON HER MEDICATION TILL A POINT I EVEN LOST HOPE,BECAUSE MY MOTHER WAS GRADUALLY DYING AND LOST HER MEMORY TOO, I WAS SO DESPERATE TO GET MY MOTHER BACK TO NORMAL, ONE DAY MY UNCLE WHO LIVES IN LONDON UNITED KINGDOM TOLD ME ABOUT DR OLIHA ,WHO HELPED HIM GET RID OF HERPES /GENITAL WART WITH HERBAL MEDICINE AND HIS HERBAL SOAP ,I WAS SO SHOCKED WHEN HE TOLD ME ABOUT THIS ,ALTHOUGH I NEVER BELIEVE IN HERB BUT, I KEEP TO BELIEVE BECAUSE MY UNCLE CAN'T TELL ME LIES WHEN IT COMES TO HEALTH CONDITION I CONTACTED DR OLIHA VIA HIS EMAIL; OLIHA.MIRACLEMEDICINE@GMAIL.COM , YOU CAN TALK TO HIM VIA CALL OR WHATSAPP MESSENGER ON +2349038382931 , HE REPLIED AND ASK ME TO SEND MY HOME ADDRESS AND MY MOTHER'S DETAIL AND THEN I PURCHASED THE HERBAL MEDICINE,SENT ME THE HERBAL MEDICINE THROUGH COURIER SERVICE, WHEN I RECEIVED THIS HERBAL MEDICINE USED IT FOR 2 WEEKS, AND 4 DAYS OF USAGE THE WARTS FELL OFF, MY MOTHER I NOW TOTALLY CURED AND MY MOTHER IS LIVING FREE AND HAPPY AGAIN. YOU CAN TALK TO DR VIA HIS MOBILE NUMBER OR WHATS APP HIM ON +2349038382931.ALL THANKS TO DOCTOR DR OLIHA  

    ReplyDelete
  2. Just wanna say a big thank you Neme Amber for introducing me to Dr Emmanuel the great HERBALIST that helped me prepare home remedies that cured my herpes (HSV 2).
    I was infected with HSV 2 for the past two years and i was unable to get a better job cos all the company i was to get employed checked our blood test and found out that i was positive to GENITAL HERPES and i loosed employment.
    So i was desperate to get a cure so that i can live normal and get my job training.
    i earlier made some research and i contacted some doctors online but they keep on asking for money for courier after that they'll tell you that tax and so more so i became broke and frustrated.
    One day i was less busy so i decided to make latest research on herpes cure and i found a site  were everyone was talking about DR Emmanuel and herbs ability to cure herpes.
    So i discussed with Neme Amber and she explained to me that its very easy working with Dr Emmanuel so i contacted DR Emmanuel via email ( nativehealthclinic@gmail.com ) and he helped me just as he has helped others now im cured and different medical centers has tested me and approved me cured.
    so i decided to thank Neme Amber cos she made it possible for me.
    and i can also assure you that he can also help you. so if you need the service of DR emmanuel, ill put his details here so that you can easily get in touch wif him.
    his email: nativehealthclinic@gmail.com or WhatsApp him at +2348140073965.
    my Name is Grace from US,once again thanks to Neme Amber. im fucking hapy....  

    ReplyDelete