Korean Journal of Pediatrics 2007;50(5):469-475.
Published online May 15, 2007.
Closure of secundum atrial septal defect: comparison between percutaneous and surgical occlusion
Na Yeon Kim1, Hyun Jung Kwon1, Deok Young Choi1, Mi Jin Jung1, Chang Hyu Choi2, Seong Ho 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
이차공 심방 중격 결손의 폐쇄: 경피적 방법과 수술적 방법의 비교
김나연1, 권현정1, 최덕영1, 정미진1, 최창휴2, 김성호3
1가천의과학대학교 소아과학교실
2가천의과학대학교 흉부외과학교실
3한라병원 소아과
Correspondence: 
Deok Young 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.
Key Words: Atrial septal defect, Percutaneous, Surgery


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