Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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LETTER TO THE EDITOR
Year : 2014  |  Volume : 9  |  Issue : 2  |  Page : 128
Determining an optimal technique for atrial septal defect closure: percutaneous closure as a therapeutic modality of choice


1 Department of Cardiology, Aksaz Military Hospital, 48750, Mugla, Turkey
2 Department of Cardiology, Gulhane Military Medical Faculty, 06018, Ankara, Turkey
3 Department of Cardiology, Malatya Military Hospital, Malatya, Turkey

Date of Web Publication14-Mar-2014

Correspondence Address:
Emre Yalcinkaya
Department of Cardiology, Aksaz Military Hospital, 48750, Mugla
Turkey
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DOI: 10.4103/1817-1737.128865

PMID: 24791179

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How to cite this article:
Yalcinkaya E, Celik M, Bugan B. Determining an optimal technique for atrial septal defect closure: percutaneous closure as a therapeutic modality of choice. Ann Thorac Med 2014;9:128

How to cite this URL:
Yalcinkaya E, Celik M, Bugan B. Determining an optimal technique for atrial septal defect closure: percutaneous closure as a therapeutic modality of choice. Ann Thorac Med [serial online] 2014 [cited 2020 Aug 11];9:128. Available from: http://www.thoracicmedicine.org/text.asp?2014/9/2/128/128865


Sir,

We read with great interest the article by Cao et al.[1] entitled "Video-assisted thoracoscopic surgery in device closure of atrial septal defect". Cao et al. [1] in their study have reported thoracoscopic surgical closure of atrial septal defect (ASD) patients with a new technique (thoracoscopic technique and the transthoracic minimally invasive closure) in order to achieve a more esthetically acceptable outcome. Although we commend the authors for their new technique that they have provided, some comments may be of beneficial.

It has been observed in non-randomized trials that surgical closure techniques have more frequent and significant complications. [2],[3],[4] Owing to its low complication rates, being safer and cost-effective than and as effective as surgical closure, percutaneous techniques are preferred widely. [2],[3],[4]

Even the authors claimed that they achieved high technical success and good therapeutic outcomes with their safe, effective, cost-acceptable and cosmetic technique, increased incidence and severity of complications associated with the technique could be observed. Complications associated with general anesthesia, intubation, lung ventilation, thoracoscopy, pericardiotomy and atriotomy such as infections, bleeding, effusion and arrhythmogenic focus formation could prolong hospitalization, increase postoperative morbidity and alter the technique's sucsess. [2],[3],[4],[5]

Based on data and the evidence in the literature, percutaneous closure of ASD should be considered as a therapeutic modality of choice for ASD occlusion in selected patients. [2],[3],[4] In our opinion, the authors' technique could be considered as an option in patients with an unsuitable peripheral access site for percutaneous device.

 
   References Top

1.Cao H, Chen Q, Zhang GC, Hu YN, Xu F. Video-assisted thoracoscopic surgery in device closure of atrial septal defect. Ann Thorac Med 2013;8:234-5.  Back to cited text no. 1
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2.Costa RN, Ribeiro MS, Pereira FL, Pedra SR, Jatene MB, Jatene IB, et al. Percutaneous versus surgical closure of atrial septal defects in children and adolescents. Arq Bras Cardiol 2013;100:347-54.  Back to cited text no. 2
    
3.Vida VL, Barnoya J, O′Connell M, Leon-Wyss J, Larrazabal LA, Castañeda AR. Surgical versus percutaneous occlusion of ostium secundum atrial septal defects: Results and cost-effective considerations in a low-income country. J Am Coll Cardiol 2006;47:326-31.  Back to cited text no. 3
    
4.Butera G, Carminati M, Chessa M, Youssef R, Drago M, Giamberti A, et al. Percutaneous versus surgical closure of secundum atrial septal defect: Comparison of early results and complications. Am Heart J 2006;151:228-34.  Back to cited text no. 4
    
5.Al-Tarshihi MI. Comparison of the efficacy and safety of video-assisted thoracoscopic surgery with the open method for the treatment of primary pneumothorax in adults. Ann Thorac Med 2008;3:9-12.  Back to cited text no. 5
[PUBMED]  Medknow Journal  




 

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