{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:41:35Z","timestamp":1747147295843,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To study the feasibility of closure of large atrial septal defects (ASDs) using occluder devices &gt;38 mm and assess the midterm complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Feasibility and safety of large occluders &gt;38 mm and their follow\u2010up are largely unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with ASDs closed using devices &gt;38 mm were retrospectively analyzed. Since outcome of patients receiving 40 mm devices were known before, patients receiving 40 mm devices were compared with those receiving 42\u201346 mm devices on demographic, hemodynamic parameters and procedural characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 17 patients with 40\u2010mm device and 31 patients with &gt;40\u2010mm device formed the cohort. The mean echocardiographic defect size was 36.3 \u00b1 3.7 mm. In total 19 patients had deficient retroaortic margin; inferior margin was deficient in one. Larger defects needed special deployment techniques more often. There was acute technical success in all patients. Two procedures failed; one device embolization next day in a patient with deficient inferior margin needed surgery. Another elderly patient with restrictive left ventricular physiology died of multiorgan dysfunction. Two late deaths on follow\u2010up were unrelated to the procedure. All other patients had symptom improvement. There were no erosions, thromboembolism or valvar regurgitation at a median follow\u2010up of 39 (1\u201360) months. Apart from late\u2010onset atrial flutter in one, there were no arrhythmias on follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Occluders larger than 38 mm in appropriately selected patients are feasible, successful and safe in majority and often require special deployment techniques. Complications during and after the procedure were infrequent. Very large defects with any deficient margin except retroaortic rim should be excluded from device closure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27957","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T22:16:40Z","timestamp":1542061000000},"page":"466-473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Feasibility, safety and midterm follow\u2010up of patients after nonsurgical closure of atrial septal defects using very large 40\u201346 mm nitinol septal occluders"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8489-2322","authenticated-orcid":false,"given":"Kothandam","family":"Sivakumar","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Institute of Cardiovascular Diseases, Madras Medical Mission  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bijesh","family":"Viswambaran","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Institute of Cardiovascular Diseases, Madras Medical Mission  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudipta","family":"Bhattacharjya","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Institute of Cardiovascular Diseases, Madras Medical Mission  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.02.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq249"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2013.07.020"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26858"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20468"},{"key":"e_1_2_9_7_1","first-page":"21","article-title":"Utility of balloon assisted technique in transcatheter closure of very large (>35mm) atrial septal defects","volume":"4","author":"Pillai AA","year":"2014","journal-title":"Cardiovasc Diagn Ther."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.84658"},{"key":"e_1_2_9_9_1","first-page":"256","article-title":"Intraoperative device closure of atrial septal defects with minimal transthoracic invasion: A single\u2010center experience","volume":"40","author":"Zhu P","year":"2013","journal-title":"Tex Heart Inst J."},{"key":"e_1_2_9_10_1","first-page":"121","article-title":"Safety and feasibility of intraoperative device closure of atrial septal defect with transthoracic minimal invasion","volume":"41","author":"Chen Q","year":"2012","journal-title":"Eur J Cardiothorac Surg."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20248"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.164685"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10700"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8183.2009.00497.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-1235(15)30178-2"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27071"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.001254"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20011"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25175"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.15-073"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.132662"},{"key":"e_1_2_9_22_1","first-page":"65","article-title":"Percutaneous closure of atrial septal defect in adults: Very long\u2010term clinical outcome and effects on aortic and mitral valve function","volume":"27","author":"Scacciatella P","year":"2015","journal-title":"J Invasive Cardiol."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw186"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22359"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22556"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12367"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl245"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.991836"},{"key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.jacc.2003.10.030","article-title":"Incidence and clinical course of thrombus formation on atrial septal defect and patent foramen ovale closure devices in 1000 consecutive patients","volume":"43","author":"Kumsdorf U","year":"2004","journal-title":"J Am Coll Cardiol."},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht283"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.27957","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27957","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T05:52:12Z","timestamp":1694670732000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.27957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,12]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,2,15]]}},"alternative-id":["10.1002\/ccd.27957"],"URL":"https:\/\/doi.org\/10.1002\/ccd.27957","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2018,11,12]]},"assertion":[{"value":"2018-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}