الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 212 |  |  |
| | | from | 212 | | |
Abstract
Aim. To report on feasibility, efficacy, and long-term outcome of transcatheter closure of fenestrated Atrial Septal Aneurysm (ASA).
Methods. Between April 2000 and May 2020, 568 patients with fenestrated ASA underwent transcatheter closure at two large-volume Pediatric Cardiology and GUCH Units (Naples and Massa, Italy). Procedural indications were cardiac volume overload in 223 patients (39%) or prophylaxis of paradoxical embolization in 345 patients (61%). Patients’ median age and body weight of 42 (range; 2-82) years and 66 (range; 10-152) Kg, respectively. One-hundred thirty-nine patients (25%) were younger than 18 yrs.
Results. Single fenestration was found in 311 patients (55%) (group 1), while 257 patients (45%) had multi-fenestrated ASA (group 2). The procedure was successful in all but seven patients (1.2%). In group 1, closure was achieved with a single device. In group 2, one device was used in 168 patients (67%), two devices in 74 patients (28%), three devices in 12 patients (5%), and four devices in one patient (0.3%). The early complication rate was 3%, without any difference according to septal anatomy or patient’s age. At discharge, complete shunt closure was higher in group 1 (92% vs. 72%, p<0.0001), without any difference between groups at the last follow-up evaluation (100% vs. 99%, p=0.12). Procedural safety was persistent during the long-term follow-up (mean 7.2±5.4, range 0-19years): freedom from adverse events was 97% at 10-15 years. Seventeen patients (3%) were submitted to re-intervention, mostly as prophylaxis of paradoxical embolization.
Conclusion. Transcatheter closure of perforated ASA is technically feasible with excellent long-term outcomes in children and adults.