Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care

Yvonne Schneeberger; Andreas Schaefer; Lenard Conradi; Jens Brickwedel; Hermann Reichenspurner; Rainer Kozlik-Feldmann; Christian Detter

doi:10.1093/icvts/ivw366

Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care

Standard

Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care. / Schneeberger, Yvonne ; Schaefer, Andreas ; Conradi, Lenard ; Brickwedel, Jens ; Reichenspurner, Hermann ; Kozlik-Feldmann, Rainer ; Detter, Christian.

In: INTERACT CARDIOV TH, Vol. 24, No. 4, 01.04.2017, p. 603-608.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schneeberger, Y , Schaefer, A , Conradi, L , Brickwedel, J , Reichenspurner, H , Kozlik-Feldmann, R & Detter, C 2017, 'Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care', INTERACT CARDIOV TH, vol. 24, no. 4, pp. 603-608. https://doi.org/10.1093/icvts/ivw366

APA

Schneeberger, Y., Schaefer, A., Conradi, L., Brickwedel, J., Reichenspurner, H., Kozlik-Feldmann, R., & Detter, C. (2017). Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care. INTERACT CARDIOV TH, 24(4), 603-608. https://doi.org/10.1093/icvts/ivw366

Vancouver

Schneeberger Y , Schaefer A , Conradi L , Brickwedel J , Reichenspurner H , Kozlik-Feldmann R et al. Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care. INTERACT CARDIOV TH. 2017 Apr 1;24(4):603-608. https://doi.org/10.1093/icvts/ivw366

Bibtex

@article{95fddb4f36984dd990f024a2c8a7dbd6,

title = "Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care",

abstract = "Objectives: Percutaneous ostium secundum atrial septal defect (ASD II) closure has become the standard of care for treatment of congenital ASD II in adults. Nevertheless, patients are frequently ineligible for this technique due to challenging morphology. In such cases, closure via minimally invasive cardiac surgery (MICS) is an appropriate treatment option. The aim of this study is to compare outcomes of MICS and use of a percutaneous Amplatzer septal occluder (ASO) device for treatment of ASD II in adults.Methods: From July 2002 to June 2014, 95 patients underwent MICS for congenital ASD II closure. During the same period, 169 patients underwent ASO procedure. Outcomes in terms of remaining ASD II, new onset atrial fibrillation (AF), post-interventional stroke, myocardial infarction and the post procedural implementation of anticoagulation were compared.Results: Apart from age (38.3 ± 12.7 vs 49.6 ± 15.7 years, P < 0.0001) the groups did not differ in baseline characteristics. A significantly higher rate of residual ASD II was found in the ASO group at 3 months (0% vs 30.8%, P < 0.0001), 6 months (0% vs 15.9%, P < 0.0001) and 12 months follow-up (0% vs 7.1%, P = 0.005). A significantly higher rate of new-onset AF was seen in the ASO group (0% vs 9.5%, P = 0.0008).Conclusions: MICS for ASD II is a safe and reproducible procedure with 0% mortality in our cohort. More complete closure of ASD, decreased rates of new onset AF and decreased need for oral anticoagulation are the advantages of the MICS procedure. Compared with the current standard of care, the MICS approach is feasible regardless of ASD morphology.",

keywords = "Adult, Aged, Cardiac Catheterization/instrumentation, Endoscopy, Female, Heart Septal Defects, Atrial/surgery, Humans, Male, Middle Aged, Retrospective Studies, Septal Occluder Device, Standard of Care, Treatment Outcome",

author = "Yvonne Schneeberger and Andreas Schaefer and Lenard Conradi and Jens Brickwedel and Hermann Reichenspurner and Rainer Kozlik-Feldmann and Christian Detter",

year = "2017",

month = apr,

day = "1",

doi = "10.1093/icvts/ivw366",

language = "English",

volume = "24",

pages = "603--608",

journal = "INTERACT CARDIOV TH",

issn = "1569-9293",

publisher = "European Association for Cardio-Thoracic Surgery",

number = "4",

}

RIS

TY - JOUR

T1 - Minimally invasive endoscopic surgery versus catheter-based device occlusion for atrial septal defects in adults: reconsideration of the standard of care

AU - Schneeberger, Yvonne

AU - Schaefer, Andreas

AU - Conradi, Lenard

AU - Brickwedel, Jens

AU - Reichenspurner, Hermann

AU - Kozlik-Feldmann, Rainer

AU - Detter, Christian

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Objectives: Percutaneous ostium secundum atrial septal defect (ASD II) closure has become the standard of care for treatment of congenital ASD II in adults. Nevertheless, patients are frequently ineligible for this technique due to challenging morphology. In such cases, closure via minimally invasive cardiac surgery (MICS) is an appropriate treatment option. The aim of this study is to compare outcomes of MICS and use of a percutaneous Amplatzer septal occluder (ASO) device for treatment of ASD II in adults.Methods: From July 2002 to June 2014, 95 patients underwent MICS for congenital ASD II closure. During the same period, 169 patients underwent ASO procedure. Outcomes in terms of remaining ASD II, new onset atrial fibrillation (AF), post-interventional stroke, myocardial infarction and the post procedural implementation of anticoagulation were compared.Results: Apart from age (38.3 ± 12.7 vs 49.6 ± 15.7 years, P < 0.0001) the groups did not differ in baseline characteristics. A significantly higher rate of residual ASD II was found in the ASO group at 3 months (0% vs 30.8%, P < 0.0001), 6 months (0% vs 15.9%, P < 0.0001) and 12 months follow-up (0% vs 7.1%, P = 0.005). A significantly higher rate of new-onset AF was seen in the ASO group (0% vs 9.5%, P = 0.0008).Conclusions: MICS for ASD II is a safe and reproducible procedure with 0% mortality in our cohort. More complete closure of ASD, decreased rates of new onset AF and decreased need for oral anticoagulation are the advantages of the MICS procedure. Compared with the current standard of care, the MICS approach is feasible regardless of ASD morphology.

AB - Objectives: Percutaneous ostium secundum atrial septal defect (ASD II) closure has become the standard of care for treatment of congenital ASD II in adults. Nevertheless, patients are frequently ineligible for this technique due to challenging morphology. In such cases, closure via minimally invasive cardiac surgery (MICS) is an appropriate treatment option. The aim of this study is to compare outcomes of MICS and use of a percutaneous Amplatzer septal occluder (ASO) device for treatment of ASD II in adults.Methods: From July 2002 to June 2014, 95 patients underwent MICS for congenital ASD II closure. During the same period, 169 patients underwent ASO procedure. Outcomes in terms of remaining ASD II, new onset atrial fibrillation (AF), post-interventional stroke, myocardial infarction and the post procedural implementation of anticoagulation were compared.Results: Apart from age (38.3 ± 12.7 vs 49.6 ± 15.7 years, P < 0.0001) the groups did not differ in baseline characteristics. A significantly higher rate of residual ASD II was found in the ASO group at 3 months (0% vs 30.8%, P < 0.0001), 6 months (0% vs 15.9%, P < 0.0001) and 12 months follow-up (0% vs 7.1%, P = 0.005). A significantly higher rate of new-onset AF was seen in the ASO group (0% vs 9.5%, P = 0.0008).Conclusions: MICS for ASD II is a safe and reproducible procedure with 0% mortality in our cohort. More complete closure of ASD, decreased rates of new onset AF and decreased need for oral anticoagulation are the advantages of the MICS procedure. Compared with the current standard of care, the MICS approach is feasible regardless of ASD morphology.

KW - Adult

KW - Aged

KW - Cardiac Catheterization/instrumentation

KW - Endoscopy

KW - Female

KW - Heart Septal Defects, Atrial/surgery

KW - Humans

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Septal Occluder Device

KW - Standard of Care

KW - Treatment Outcome

U2 - 10.1093/icvts/ivw366

DO - 10.1093/icvts/ivw366

M3 - SCORING: Journal article

C2 - 28040751

VL - 24

SP - 603

EP - 608

JO - INTERACT CARDIOV TH

JF - INTERACT CARDIOV TH

SN - 1569-9293

IS - 4

ER -