EDITORIALS
Secundum atrial septal defects: time to close them all?
1 Imperial College Healthcare NHS Trust, London, UK
Correspondence to:
Dr I Malik, Imperial College Healthcare NHS Trust, St Mary’s Campus, Waller Department of Cardiology, Praed Street, London W2 1NY, UK; i.malik@imperial.ac.uk
| The first 150 words of the full text of this article appear below. |
Catheter-based closure is now considered the first-line treatment strategy for secundum atrial septal defects (ASD). Although in some cases, surgery remains the only option (eg, for those with an insufficient rim to secure a device, or those with coincidental anomalous pulmonary venous return), a percutaneous approach is suitable for the vast majority of patients with secundum ASD. As skill and experience grow, defects as large as 40 mm in size have been successfully closed in this manner.
In the days when repairing any ASD required a thoracotomy, cardiopulmonary bypass and 4 days or more in hospital, the benefits from treatment had to markedly overcome the deleterious effects of surgery, including the effects on the right ventricle of opening the pericardium and going on bypass. With less invasive treatments available, the question to be asked is—just because we can, should we be closing them all? The evidence seems to be clear
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Heart 2008 94: 1189-1193.[Abstract] [Full Text] [PDF]
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