PMID- 33667439
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20210617
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 147
DP  - 2021 May 15
TI  - Transcatheter Closure of Atrial Septal Defect Associated With Pulmonary Artery 
      Hypertension using Fenestrated Devices.
PG  - 122-128
LID - S0002-9149(21)00096-5 [pii]
LID - 10.1016/j.amjcard.2021.01.025 [doi]
AB  - In patients with pulmonary artery hypertension (PAH) associated with atrial 
      septal defect (ASD), closure of ASD may carry significant risks. We aimed to 
      evaluate the safety and efficacy of transcatheter closure of ASD in selected 
      patients with PAH using a fenestrated device followed by pulmonary vasodilator 
      therapy. During the 14.8-year period, 51 ASD patients (10 males, age 46 +/- 18 
      years) with a mean pulmonary artery pressure (PAP) >/= 35 mm Hg and/or systolic PAP 
      >/= 60 mm Hg, underwent closure with a fenestrated device. Of them, mean Qp/Qs 
      ratio, systolic PAP and mean PAP were 2.6 +/- 1.2, 73 +/- 14 mm Hg, and 44 +/- 8 mm Hg, 
      respectively. A total of 35 patients received pulmonary vasodilator therapy. The 
      New York Heart Association (NYHA) functional class improved at 3 to 6 months 
      follow-up. (p < 0.001) Nineteen patients underwent repeated catheterization. A 
      comparison of the hemodynamic parameters between baseline and repeated 
      catheterization revealed significant decreases in both systolic and mean PAP (77 
      +/- 11 vs 55 +/- 14 mm Hg, p < 0.0001 & 48 +/- 7 vs 37 +/- 8 mm Hg, p = 0.001, 
      respectively), pulmonary vascular resistance (PVR) (5.1 +/- 2.3 vs 4.0 +/- 1.7 WU, 
      p = 0.011) and PVRi (7.7 +/- 3.3 vs 6.2 +/- 2.4 WU*m2, p = 0.024). After a follow-up 
      period of 84 +/- 45 months, 6 mortalities were noted in which 2 were due to cardiac 
      causes. In conclusion, catheter closure of ASD in patients with PAH using a 
      fenestrated device followed by vasodilator therapy is safe and effective.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Wang, Jou-Kou
AU  - Wang JK
AD  - Department of pediatrics, National Taiwan University Hospital, and medical 
      college, National Taiwan University, Taipei, Taiwan. Electronic address: 
      jkww@ntuh.gov.tw.
FAU - Chiu, Shuen-Nan
AU  - Chiu SN
AD  - Department of pediatrics, National Taiwan University Hospital, and medical 
      college, National Taiwan University, Taipei, Taiwan.
FAU - Lin, Ming-Tai
AU  - Lin MT
AD  - Department of pediatrics, National Taiwan University Hospital, and medical 
      college, National Taiwan University, Taipei, Taiwan.
FAU - Chen, Chun-An
AU  - Chen CA
AD  - Department of pediatrics, National Taiwan University Hospital, and medical 
      college, National Taiwan University, Taipei, Taiwan.
FAU - Lu, Chun-Wei
AU  - Lu CW
AD  - Department of pediatrics, National Taiwan University Hospital, and medical 
      college, National Taiwan University, Taipei, Taiwan.
FAU - Wu, Mei-Hwan
AU  - Wu MH
AD  - Department of pediatrics, National Taiwan University Hospital, and medical 
      college, National Taiwan University, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210303
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Vasodilator Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cardiac Catheterization/*instrumentation
MH  - Cohort Studies
MH  - Female
MH  - Heart Septal Defects, Atrial/*complications/mortality/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Arterial Hypertension/*complications
MH  - *Septal Occluder Device
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Vasodilator Agents/therapeutic use
MH  - Young Adult
EDAT- 2021/03/06 06:00
MHDA- 2021/06/22 06:00
CRDT- 2021/03/05 20:10
PHST- 2020/09/25 00:00 [received]
PHST- 2021/01/10 00:00 [revised]
PHST- 2021/01/13 00:00 [accepted]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2021/03/05 20:10 [entrez]
AID - S0002-9149(21)00096-5 [pii]
AID - 10.1016/j.amjcard.2021.01.025 [doi]
PST - ppublish
SO  - Am J Cardiol. 2021 May 15;147:122-128. doi: 10.1016/j.amjcard.2021.01.025. Epub 
      2021 Mar 3.