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LETTER TO EDITOR
Year : 2014  |  Volume : 55  |  Issue : 5  |  Page : 441-442  

Percutaneous closure of atrial septal defect and persistent fossa ovalis: Nuances with implications


1 Department of Surgery, Division of Cardiothoracic Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt; Department of Surgery, Division of Cardiothoracic Surgery, Federal Medical Centre, Owerri, Nigeria
2 Department of Surgery, Division of Cardiothoracic Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
3 Department of Paediatrics, Division of Paediatric Cardiology, Federal Medical Centre, Owerri, Nigeria

Date of Web Publication9-Sep-2014

Correspondence Address:
Kelechi E Okonta
Department of Surgery, Division of Cardiothoracic Surgery, University of Port Teaching, PortHarcourt
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0300-1652.140395

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How to cite this article:
Okonta KE, Ocheli EO, Iregbu FU. Percutaneous closure of atrial septal defect and persistent fossa ovalis: Nuances with implications. Niger Med J 2014;55:441-2

How to cite this URL:
Okonta KE, Ocheli EO, Iregbu FU. Percutaneous closure of atrial septal defect and persistent fossa ovalis: Nuances with implications. Niger Med J [serial online] 2014 [cited 2019 Nov 18];55:441-2. Available from: http://www.nigeriamedj.com/text.asp?2014/55/5/441/140395

The management of atrial septal defect (ASD) via percutaneous closure has been with us for about four decades with some successive modifications in order to achieve perfect closure and improve patient outcome. Therefore, there is no ambiguity whatsoever on surgical versus percutaneous procedures. [1] Importantly, not all ASD is treated by percutaneous closure technique, and not even the secundum septal defect whose anatomy is properly adapted for percutaneous closure is universally treated with such (percutaneous occlusion) technique. Thus in describing the treatment of ASD, it is imperative to clearly state what treatment option is adopted; either medical approach (of which percutaneous closure is included) or surgical. And as percutaneous therapies are gradually replacing surgical repair of ASD (secundum defect), proper preoperative assessment of the patient and the anatomy by using echocardiography cannot be overemphasised. [2] Complications resulting from the use of the percutaneous closure ranges from minor to life-threatening and potentially fatal as such long-term follow-up is necessary to completely estimate the safety and efficacy of the devices. [2],[3] The knowledge of the potential complications of device closure and their predictors will help in reducing their future occurrence. [3]

In some of the defects like sinus venosus defect, the proper application of surgical option is associated with low morbidity and mortality. [4] However, there is the requirement of cardiopulmonary bypass carrying some risk and complications like sinus node dysfunction and venous obstruction. [4] In conclusion, neither percutaneous nor surgical procedures are used exclusively in all settings. The choice of procedure rests on proper patient assessment and determination of the type of lesion present is important as this would ensure optimal outcome.

 
   References Top

1.Adiele DK, Chinawa JM, Arodiwe IO, Gouthami V, Murthy KS, Eze JC, et al. Atrial septal defects: Pattern, clinical profile, surgical techniques and outcome at Innova heart hospital: A 4-year review. Niger Med J 2014;55:126-9.  Back to cited text no. 1
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2.Yared K, Baggish AL, Solis J, Durst R, Passeri JJ, Palacios IF, et al. Echocardiographic assessment of percutaneous patent foramen ovale and atrial septal defect closure complications. Circ Cardiovasc Imaging 2009;2:141-9.  Back to cited text no. 2
    
3.Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 Guidelines for the management of adults with Congenital Heart Disease: Executive Summary: A report of the American College of Cardiology/American Heart Association task force on Practice Guidelines. (writing committee to develop guidelines for the management of adults with congenital heart disease). Circulation 2008;118:2395-45.  Back to cited text no. 3
    
4.Okonta KE, Sanusi M. Superior sinus venosus atrial septal defect: Overview of surgical options. Open J Thorac Surg 2013;3:114-22.  Back to cited text no. 4
    




 

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