All issues > Volume 50(5); 2007

Original Article

Korean J Pediatr. 2007;50(5):469-475. Published online May 15, 2007.

Closure of secundum atrial septal defect: comparison between percutaneous and surgical occlusion

Na Yeon NY Kim¹, Hyun Jung HJ Kwon¹, Deok Young DY Choi¹, Mi Jin MJ Jung¹, Chang Hyu CH Choi², Seong Ho SH Kim³

¹Department of Pediatrics, Gil Medical Center, Gachon, Korea
²Department of Thoracic and Cardiovascular Surgery, Gil Medical Center, Gachon, Korea
³University of Medicine, Incheon, Department of Pediatrics, Halla General Hospital, Jeju, Korea

Correspondence Deok Young DY Choi ,Email: pskcdy@hanmail.net

Abstract

Purpose
: This study was performed to compare the safety, efficacy and clinical results of the Amplatzer septal occluder (ASO) for closure of secundum atrial septal defect (ASD) with surgery.
Methods
: One hundred fifteen patients diagnosed as isolated secundum ASD in Gil Medical Center, Gachon University of Medicine from January 2000 to July 2006 were included. Seventy patients underwent surgical repair of ostium secundum ASD. Forty-five consecutive patients were treated with percutaneous closure using ASO. We compared the mortality, morbidity, hospital stay, and efficacy between two groups.
Results
: Male to female ratio was 1:2.4. The mean age and the size of defects were not statistically different. No mortality occurred in either group. The success rate was 97.8% in the device group and 100% in the surgical group. The overall rate of complications was higher in the surgical group than in the device group (64.0 vs. 15.6%, P<0.05). Hospital stay was shorter in the device group than in the surgical group (4.2?.2 vs. 12.4?.7 days, P<0.0001). Residual shunt rates were more frequent in the device group (8.9%) than in the surgical group (4.3%) at discharge. All residual shunts disappeared at 3 months follow-up.
Conclusion
: Percutaneous closure of ASD using ASO is a safe and effective alternative to surgical repair. The indications of percutaneous ASD closure with ASO would be expanded by accumulation of experiences and evolutions of device.

Keywords :Atrial septal defect, Percutaneous, Surgery