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Meta-Analysis
. 2023 Mar-Apr;75(2):145-152.
doi: 10.1016/j.ihj.2023.01.008. Epub 2023 Feb 1.

Sufficient versus deficient rims during percutaneous closure of ostium secundum type atrial septal defect: A systematic review and meta-analysis

Alejandro E Contreras  1 , Facundo Ledesma  2 , Alejandro R Peirone  3 , Ernesto Juaneda  3 , Victor Defago  2 , Eduardo Cuestas  2
Affiliations
Meta-Analysis

Sufficient versus deficient rims during percutaneous closure of ostium secundum type atrial septal defect: A systematic review and meta-analysis

Alejandro E Contreras et al. Indian Heart J. 2023 Mar-Apr.

Abstract

Background: The aim of this meta-analysis was to compare the efficacy and adverse events of percutaneous occlusion among patients with sufficient and deficient rims.

Methods: A systematic review of all articles published in the Pubmed, MEDLINE and Google Scholar databases was performed. Odds ratio (OR) and 95% CI were used as a measure of effect of the combination of studies. I2 with 95% CI was estimated to assess study heterogeneity. For the meta-analysis, a random effects model was used.

Results: The systematic search identified ten studies which included 4355 patients; 2661 of those had sufficient rim and the remaining 1694 patients showed some rim deficiency. Implant failure rate was 4.13% CI 95% 3.53-4.72%. Compared to frequency of failures in the group with a deficient rim (5.43% CI 95% 4.35-6.50%), implant failure in patients with a sufficient rim was significantly lower (3.30% CI 95% 2.62-3.97%), OR 2.27 CI 1.34-3.83 (p 0.002). The combined adverse events were 5.19% CI 95% 4.22-6.35% vs 2.7% CI 95% 2.08-3.31% in the deficient vs sufficient rim groups respectively (OR 2.21 CI 0.93-5.29; p 0.07). Implant failures and adverse events were more frequent in patients with posterior inferior rim deficiency.

Conclusion: Patients presenting a posteroinferior rim deficiency are associated to both, an increased incidence of closure failure and a combined adverse events occurrence. More studies on posterior rim deficiency are necessary to ensure the feasibility and safety of the percutaneous approach.

Keywords: Adverse events; Atrial septal defect; Echocardiography; Efficacy.

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Conflict of interest statement

Declaration of competing interest No author has conflicts of interest. The authors have not received financial support for the development of the research.

Figures

Fig. 1
Fig. 1
Flow chart showing search results and selection of the studies included in the meta-analysis.
Fig. 2
Fig. 2
Forest plot reflecting failure of implant (A) and follow-up adverse events after procedural closure (B) of ASD.
Fig. A1
Fig. A1
Forest plot reflecting failure of implant (A) and follow-up adverse events after procedural closure (B) of ASD in aortic rim deficiency.
Fig. A2
Fig. A2
Forest plot reflecting failure of implant (A) and follow-up adverse events after procedural closure (B) of ASD in posterior inferior rim deficiency.
See this image and copyright information in PMC

References

    1. Baumgartner H., De Backer J., Babu-Narayan S.V., et al. ESC Scientific Document Group. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J. 2021 Feb 11;42(6):563–645. doi: 10.1093/eurheartj/ehaa554. - DOI - PubMed
    1. Stout K.K., Daniels C.J., Aboulhosn J.A., et al. AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol. 2018;73(12):e81–e192. doi: 10.1016/j.jacc.2018.08.1029. 2019 Apr 2. - DOI - PubMed
    1. Amin Z., Hijazi Z.M., Bass J.L., Cheatham J.P., Hellenbrand W.E., Kleinman C.S. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Cathet Cardiovasc Interv. 2004 Dec;63(4):496–502. doi: 10.1002/ccd.20211. - DOI - PubMed
    1. Batteux C., Azarine A., Karsenty C., et al. Sinus venosus ASDs: imaging and percutaneous closure. Curr Cardiol Rep. 2021 Aug 19;23(10):138. doi: 10.1007/s11886-021-01571-7. - DOI - PubMed
    1. Huang L.L., Wu J., Chen M., et al. Transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim under echocardiography only: a feasibility and safety analysis. Cardiol Young. 2021 Jul 12:1–8. doi: 10.1017/S104795112100264X. - DOI - PubMed