ASSESSMENT OF THE RESULTS OF SECUNDUM ATRIAL SEPTAL DEFECT CLOSURE BY TWO METHODS: SURGERY (RIGHT THORACOTOMY) AND INTERVENTION (TRANSCATHETER AMPLATZER SEPTAL OCCLUDER)

Abstract

Background: Secondary atrial septal defect is one of the most common congenital heart diseases, and treatment is required in cases of large defects. The aim of this study was to assess the short-term results of secundum atrial septal defect closure by two methods: surgery (right thoracotomy) and intervention (transcatheter Amplatzer septal occluder).<br />Methods: This is a descriptive study on 25 patients treated by one of the two above-mentioned methods at our center between 2004 and 2007. The patients underwent clinical and diagnostic examinations both before and after treatment such as chest X-ray, electrocardiography, echocardiography, catheterization, and angiography. The outcome and results were thereafter assessed and compared.<br />Results: The study population was comprised of 20 (80%) females and 5 (20%) males. The patients were divided into two groups: 17 (68%) patients were treated by intervention and 8 (32%) by right thoracotomy. The intervention group had a mean age of 12 years (±6years) and the surgery group 11 years (±4 years). The average size of the defect was approximately 15 mm, which was similar in both groups. The average duration of hospital stay in the intervention group was significantly shorter than that of the surgery group, and the average cost of treatment in the intervention group was slightly less than the surgery group. One of the patients in the surgery group needed blood transfusion, and one of the patients in the intervention group suffered from Amplatzer embolization to the left ventricle, necessitating the extraction of the device through open heart surgery. One of the patients in the surgery group had a residual defect in the atrial septum, which was not significant.<br />Conclusion: In light of the results of this study, it seems that in appropriately selected patients, the closure of the atrial septal defect via the interventional method is comparable to surgery.