{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:48:43Z","timestamp":1776692923016,"version":"3.51.2"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T00:00:00Z","timestamp":1463529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 HL007915"],"award-info":[{"award-number":["T32 HL007915"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Concern regarding aortic erosion has focused attention on the retro\u2010aortic rim in patients undergoing device closure of atrial septal defects (ASD), but its effect on early outcomes is not well studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter retrospective cohort study of patients undergoing device occlusion of ASD between 1\/2011\u201010\/2014 was performed, using data from the IMproving Pediatric and Adult Congenital Treatment Registry. Subjects were divided between those with retro\u2010aortic rim &lt;5 and \u22655 mm. Primary outcomes were technical failure and major early adverse events. Case times were measured as surrogates of technical complexity. The effect of deficient retro\u2010aortic rim on primary outcomes was assessed using hierarchical logistic regression, adjusting for other suspected covariates and assessing whether they represent independent risk factors<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1,564 subjects (from 77 centers) were included, with deficient retro\u2010aortic rim present in 40%. Technical failure occurred in 91 subjects (5.8%) and a major early adverse event in 64 subjects (4.1%). Adjusting for known covariates, the presence of a deficient retro\u2010aortic rim was not significantly associated with technical failure (OR: 1.3, 95% CI: 0.9\u20132.1) or major early adverse event (OR: 0.7, 95% CI: 0.4\u20131. 2). Total case (<jats:italic>P<\/jats:italic>\u2009=\u20090.01) and fluoroscopy time (<jats:italic>P<\/jats:italic>\u2009=\u20090.02) were greater in subjects with deficient rim, but sheath time was not significantly different (<jats:italic>P<\/jats:italic>\u2009=\u20090.07). Additional covariates independently associated with these outcomes were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Deficient retro\u2010aortic rim was highly prevalent but not associated with increased risk of technical failure or early adverse events. Studies with longer follow\u2010up are necessary to assess other outcomes, including device erosion. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26585","type":"journal-article","created":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T13:06:36Z","timestamp":1463576796000},"page":"102-111","source":"Crossref","is-referenced-by-count":25,"title":["The influence of deficient retro\u2010aortic rim on technical success and early adverse events following device closure of secundum atrial septal defects"],"prefix":"10.1002","volume":"89","author":[{"given":"Michael L.","family":"O'Byrne","sequence":"first","affiliation":[{"name":"Division of Cardiology Children's National Medical Center, George Washington University School of Medicine and Health Sciences"},{"name":"Department of Pediatrics George Washington University School of Medicine and Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children's Hospital of Philadelphia"},{"name":"Department of Pediatrics Perelman School of Medicine, The University of Pennsylvania Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin F.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Mid America Heart Institute St. Luke's Health System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoav","family":"Dori","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children's Hospital of Philadelphia"},{"name":"Department of Pediatrics Perelman School of Medicine, The University of Pennsylvania Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Rome","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children's Hospital of Philadelphia"},{"name":"Department of Pediatrics Perelman School of Medicine, The University of Pennsylvania Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Glatz","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children's Hospital of Philadelphia"},{"name":"Department of Pediatrics Perelman School of Medicine, The University of Pennsylvania Philadelphia"},{"name":"Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine at the University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1001\/jama.1976.03260490024013","article-title":"Secundum atrial septal defect. 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