Comparison of surgery versus domestic-made ASD occluder device implantation.in the closure of atrial septal defectsChinese Full Text

DAI Zheng-xue~1, GUO You-xing~3,FAN Chuan-min~4, ZHANg Yu-shun, WANG Hai-chang~1, JIA Guo-liang~1,LI Huan~1,LIU Jian-ping~1,ZHANG Jun~2, LI Jun~2, WANG Xiao-yan~1 (1.Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi′an,Shaanxi 710032,China)

Abstract: AIM: To compare effectiveness, complications, and cost of domestic-made ASD occluder with surgical in atrial septal defect （ASD） closure. METHODS: We prospectively compared closure rates , complication rates, regression of right ventricular dilatation (up to one year postprocedure, cost, inpatient stay, and home convalescent time in 378 patients with secundum atrial septal defects: 156 cases （22±16 years） were treated surgically and 222 cases（24±17 years） were treated by percutaneous domestic-made ASD septal occluder . RESULTS: domestic-made ASD occluder closure was successful in 200 of 222 （99.1%） patients. Surgical closure was successful in all 222 cases. Cardiac complications affecting management occurred in two （0.9%） of the domestic-made ASD occluder group （one procedural failures, one stoke） and 5 of 156 （3.2%） surgical patients （one pericardial pain, 2 global pericardial effusion requiring drainage, and two patient with anaemia requiring haematinics） . There were complications that did not affect management in a further 45 of 156 surgical patients and 9 of 222 domestic-made ASD occluder group. There was no significant difference in regression of right ventricular dilatation by six months postprocedure （median right ventricular end diastolic diameter decrease: domestic-made ASD occluder group 17.5%, surgical group 15.1%）. Blood products were administered to 76 patients in the surgical group and no patient in the device group （P＜ 0.01）. Both hospital stay and home convalescent times were significantly shorter after domestic-made ASD occluder closure （median hospital stay: domestic-made ASD occlude 3.57±1.89 days, surgery 13.41±5.74 days; median convalescent time: domestic-made ASD occluder two weeks, surgery 6 weeks）. Median cost was similar for both groups （domestic-made ASD occluder RMB2456±542, surgical RMB 2236±742, P＞0.05）. CONCLUSION: Transcatheter closure of secundum atrial septal defects with the domestic-made ASD occluder device has the advantage of fewer complications, shorter hospitalization, and reduced need of blood products. Nonetheless, the surgeon’s ability to close any atrial septal defect regardless of its size or location remains an important advantage of surgery.

Keywords：

domestic-made ASD occluder; atrial septal defect; surgery;

DOI：
10.13191/j.chj.2005.03.88.daizhx.038
Series：
Subject：
Classification Code：
R654.2

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Comparison of surgery versus domestic-made ASD occluder device implantation.in the closure of atrial septal defectsChinese Full Text

DAI Zheng-xue~1, GUO You-xing~3,FAN Chuan-min~4, ZHANg Yu-shun, WANG Hai-chang~1, JIA Guo-liang~1,LI Huan~1,LIU Jian-ping~1,ZHANG Jun~2, LI Jun~2, WANG Xiao-yan~1 (1.Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi′an,Shaanxi 710032,China)

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