{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T19:19:36Z","timestamp":1769195976163,"version":"3.49.0"},"reference-count":18,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T00:00:00Z","timestamp":1532304000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"},{"start":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T00:00:00Z","timestamp":1532304000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951118001099_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>The outcome of transcatheter closure in ostium secundum atrial septal defects is determined by the morphology of the defects. Modified techniques such as balloon assistance, pulmonary vein deployment, left atrial roof technique, and so on are used for circumventing the anatomic complexities and increasing the success rates.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951118001099_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We planned a prospective study looking at the outcomes of transcatheter closure in secundum atrial septal defects with modified techniques in different anatomic complexities identified in transoesophageal echocardiography and their association with outcome of transcatheter closure.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951118001099_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Transcatheter closure was successful in 295 out of 346 (82%) patients with modified techniques. Balloon-assisted technique offered a success rate of 87%. The mean defect size was 34.7\u00b12.78 mm (95% confidence interval (CI) 30.67\u201343.1 mm) with success and 40.16\u00b14.5 mm (95% CI 32.16\u201344.7) with failure (p = 0.02). The mean total septal length was 38.11\u00b10.63 (95% CI 35.21\u201340.56 mm) with success and 42.54\u00b10.34 (95% CI 38.79\u201343.21 mm) with failure. The defect to septal ratios were 0.82 and 0.94 in success and failure groups, respectively (p=0.02). However, the absence of a retro-aortic margin, septal aneurysm, and multiple defects did not affect the success rate. Deficient inferior vena caval margin, deficient posterior margin, and size\u2a7e40 mm had a high risk of failure with transcatheter closure. The odds ratio for procedural failure was 25.3 (4.3\u2013143.8) in patients with malaligned septum, 8.3(1.4\u201348.5) with deficient inferior vena caval margin, and 4.1(2.5\u201319) for size\u2a7e40 mm.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951118001099_abs4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>The modified techniques for device deployment offer substantial chances of success in transcatheter closure of secundum atrial septal defects with anatomical complexity (82%). Variants such as defect size of\u2a7e40 mm and deficient inferior and posterior margins have high failure rates with a modified technique.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951118001099","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T07:53:17Z","timestamp":1532332397000},"page":"1122-1133","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Impact of modified techniques of transcatheter closure in large atrial septal defects (\u2a7e30 mm) with anatomic complexities"],"prefix":"10.1017","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6860-5765","authenticated-orcid":false,"given":"Ajith","family":"Ananthakrishna Pillai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amarnath","family":"Upadhyay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saranya","family":"Gousy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Handa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2018,7,23]]},"reference":[{"key":"S1047951118001099_ref13","first-page":"21","article-title":"Utility of balloon assisted technique in trans catheter closure of very large (\u226535 mm) atrial septal defects","volume":"4","author":"Pillai","year":"2014","journal-title":"Cardiovasc Diagn Ther"},{"key":"S1047951118001099_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26369"},{"key":"S1047951118001099_ref1","first-page":"1135","article-title":"Canadian Cardiovascular Society Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease part III","volume":"17","author":"Therrien","year":"2001","journal-title":"Can J Cardiol"},{"key":"S1047951118001099_ref17","doi-asserted-by":"publisher","DOI":"10.15171\/jcvtr.2016.07"},{"key":"S1047951118001099_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12284"},{"key":"S1047951118001099_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(05)80191-7"},{"key":"S1047951118001099_ref4","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20248"},{"key":"S1047951118001099_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10686"},{"key":"S1047951118001099_ref11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019987"},{"key":"S1047951118001099_ref6","first-page":"90","article-title":"A modified Cook sheath for closure of a large secundum atrial septal defect","volume":"73","author":"Spies","year":"2007","journal-title":"Catheter Cardiovasc Interv"},{"key":"S1047951118001099_ref3","doi-asserted-by":"publisher","DOI":"10.2459\/01.JCM.0000203852.82643.f2"},{"key":"S1047951118001099_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2013.12.016"},{"key":"S1047951118001099_ref16","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12365"},{"key":"S1047951118001099_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2014.09.002"},{"key":"S1047951118001099_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.001"},{"key":"S1047951118001099_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10700"},{"key":"S1047951118001099_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20872"},{"key":"S1047951118001099_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26497"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951118001099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,13]],"date-time":"2019-04-13T15:33:10Z","timestamp":1555169590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951118001099\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,23]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["S1047951118001099"],"URL":"https:\/\/doi.org\/10.1017\/s1047951118001099","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,23]]},"assertion":[{"value":"\u00a9 Cambridge University Press 2018\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}