Abstract
An: 2010, Nr.1, Articol Nr. 18
Title: 

COMPARISON BETWEEN PERCUTANEOUS AND SURGICAL CLOSURE OF ATRIAL SEPTAL DEFECTS

Authors: 

      Alina Guţu, A.G. Dimitriu - “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Faculty of Medicine
      Cezara Răileanu, I. Nedelciuc, L. Stoica - Institute of Cardiovascular Diseases, “Prof.Dr. G.I.M. Georgescu”, Iasi
      G. Tinică - “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Faculty of Medicine; Institute of Cardiovascular Diseases, “Prof.Dr. G.I.M. Georgescu”, Iasi
      COMPARISON BETWEEN PERCUTANEOUS AND SURGICAL CLOSURE OF ATRIAL SEPTAL DEFECTS (Abstract): The aim of this study was to compare results, complications and hospital costs of surgical versus transcatheter treatment of atrial septal defect (ASD). Material and method: 2 years retrospective study on 15 patients with a secundum atrial septal defect and pulmonary/systemic flow ratio of 1,5:1 or more who presented between January 2008 and December 2009. Six patients had the defect closed with an Amplatzer device ( AGA Medical Corporation, GoldenValley, Minn.). 9 patients in whom interventional closure could not be performed, underwent surgical closure. Baseline physical exams, EKG, pulmonary X-ray and echocardiography were performed preprocedure and at follow-up Hospital costs were calculated for every patient who underwent either of the two procedures. Results: The median age was similar in both groups. The size of the ASD was 12.25±3.71 mm for the device group and larger, 26.3±6.7 mm in the surgery group( p<0.001). Closure rates in the 2 groups were identical (100%). The complication rate was 0 % for the device group and 55,5% for the surgical group, but minor complications. Hospital stay in surgically treated patients was 17±4 days versus 4,5±2 days for the interventionally treated patients (p<0.001)). Home convalescent times was significantly shorter after Amplatzer closure (p<0.001). Median costs for surgical versus device closure was not statistically different. Mortality was 0% for both groups. Conclusions: As complete closure rates is identical, but duration of hospital stay is shorter with less complications and morbidity, we prefer implantation of an Amplatzer septal occluder to surgery wherever possible.
Key words: ATRIAL SEPTAL DEFECT, AMPLATZER SEPTAL OCLUDER
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