ASD Repair in Adolescent and Adult Patients, and Establishing a Heart
Team in Low-Volume Centres: Should it be the Current Standard of Care?
Abstract
Objectives: A retrospective review of adolescent and adult patients with
Atrial Septal Defect (Secundum ASD) who underwent secundum ASD closure
by transcatheter closure (TCC) or surgery at Jordan University Hospital
(JUH). We seek to illustrate the importance of a multidisciplinary Heart
Team in low-volume centres, and report the experience and outcomes of
this approach. Methodology: A retrospective observational study of 42
patients who underwent secundum ASD closure by TCC or surgery at JUH. We
utilised the hospital’s electronic record system to attain patients’
information, and SPSS and Microsoft Excel were used to analyse the data.
Results: 42 patients with secundum ASD were treated during the period
between January 2015 and December 2019. The mean age of participants was
34.1 (± 14.3). A total of 34 patients underwent TCC, seven surgical
closure, and one a hybrid approach. There were no incidents of
mortality, but two minor morbidities were reported. After an average
follow-up period of 13.2-/+13.6 months, with a range of 1-47 months ,
most patients experienced an improvement in their symptoms. There was
also a significant reduction of the right ventricular dimension:
Conclusion: A Heart Team approach is necessary as the use of minimally
invasive cardiac surgery MICS and Transcatheter closure TCC continues to
advance. A Heart Team provides patients with a variety of safe and
cosmetic solutions that facilitate rapid management and recovery by
encouraging the merits and avoiding the complications of each modality.
Ultimately, the Heart Team allows low-volume centres to achieve
excellent outcomes.