An overview of treatment for atrial septal defect with pulmonary hypertension
Abstract
Background: Atrial Septal Defect (ASD) is a congenital heart defect which can be the cause of comorbidities in the form of Pulmonary Arterial Hypertension (PAH) and therapy cannot be done simply by correcting the ASD but requires further study and evaluation.
Purpose: Describe the treatment given to patients with ASD and PAH and the correlation between the administration of interventional therapy and the patient's probability of PH.
Method: This study is a descriptive quantitative using a cross-sectional research design. The sampling technique was total sampling method. The samples were 41 ASD patients with PAH at Prof. Ngoerah General Hospital in Denpasar in 2022. Patients under 18 years of age and those with other congenital heart disease will be excluded. The demographic characteristics assessed were the patient's age and gender. The therapy data included information on medical therapy and intervention therapy.
Results: Focus of medical therapy was supportive therapy rather than specific PAH therapy. Percutaneous ASD closure was the most widely-used intervention therapy compared to surgical ASD closure. Based on statistical analysis, the p value > 0.05 is 0.284, so there is no significant correlation between the probability of the patient's pH and the provision of intervention therapy.
Conclusion: At Prof Ngoerah General Hospital Denpasar, the majority of ASD patients with complications of pulmonary hypertension were females aged between 21 to 30 years. The medical therapy given is adjusted based on the severity of PH as assessed through echocardiography examination. Majority of patients received supportive therapy compared to specific therapy for PAH. Medical therapy is prioritized for patients who have contraindication criteria for interventional therapy. Percutaneous ASD Closure was found to be the largest percentage in interventional therapy regardless of the severity, except for patients who were indicated to undergo surgical ASD closure. There is no significant relationship between the patient's PH probability level and the choice of intervention therapy.
Keywords
References
Alkashkari, W., Albugami, S., & Hijazi, Z. M. (2020). Current practice in atrial septal defect occlusion in children and adults. In Expert Review of Cardiovascular Therapy (Vol. 18, Issue 6, pp. 315–329). Taylor and Francis Ltd. https://doi.org/10.1080/14779072.2020.1767595
Aoki, H., & Horie, M. (2018). Electrical disorders in atrial septal defect: Genetics and heritability. In Journal of Thoracic Disease (Vol. 10, pp. S2848–S2853). AME Publishing Company. https://doi.org/10.21037/jtd.2018.02.53
Asmayadi, L. A. (2018). Assessment of Tricuspid Function Atrial Septal Defect (ASD) in Patient with Echocardiography. ARKAVI: Arsip Kardio Vaskular Indonesia, 3(2), 2009–2011.
Bossone, E., D’Andrea, A., D’Alto, M., Citro, R., Argiento, P., Ferrara, F., & Naeije, R. (2013). Echocardiography in pulmonary arterial hypertension: from diagnosis to prognosis. Journal of the American Society of Echocardiography, 26(1), 1-14.
Dalvi, B., Jain, S., & Pinto, R. (2019). Device closure of atrial septal defect with severe pulmonary hypertension in adults: Patient selection with early and intermediate term results. Catheterization and Cardiovascular Interventions, 93(2), 309–315. https://doi.org/10.1002/ccd.27853
Dinarti, L. K., Hartopo, A. B., Kusuma, A. D., Satwiko, M. G., Hadwiono, M. R., Pradana, A. D., & Anggrahini, D. W. (2020). The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry: A descriptive study from single-center hospital registry of adult congenital heart disease and pulmonary hypertension in Indonesia. BMC Cardiovascular Disorders, 20(1). https://doi.org/10.1186/s12872-020-01434-z
Faccini, A., & Butera, G. (2018). Atrial septal defect (ASD) device trans-catheter closure: Limitations. In Journal of Thoracic Disease (Vol. 10, pp. S2923–S2930). AME Publishing Company. https://doi.org/10.21037/jtd.2018.07.128
Fraisse, A., Latchman, M., Sharma, S. R., Bayburt, S., Amedro, P., Di Salvo, G., & Baruteau, A. E. (2018). Atrial septal defect closure: Indications and contra-indications. In Journal of Thoracic Disease (Vol. 10, pp. S2874–S2881). AME Publishing Company. https://doi.org/10.21037/jtd.2018.08.111
Habibah, S. (2018). Manajemen Hipertensi Pulmonal Perioperatif pada Bedah Jantung. JAI (Jurnal Anestesiologi Indonesia), 10(3), 188. https://doi.org/10.14710/jai.v10i3.20724
Hoeper, M. M., Ghofrani, H. A., Grünig, E., Klose, H., Olschewski, H., & Rosenkranz, S. (2017). Pulmonary hypertension. Deutsches Arzteblatt International, 114(5), 73–84. https://doi.org/10.3238/arztebl.2017.0073
Humbert, M., Kovacs, G., Hoeper, M. M., Badagliacca, R., Berger, R. M. F., Brida, M., Carlsen, J., Coats, A. J. S., Escribano-Subias, P., Ferrari, P., Ferreira, D. S., Ghofrani, H. A., Giannakoulas, G., Kiely, D. G., Mayer, E., Meszaros, G., Nagavci, B., Olsson, K. M., Pepke-Zaba, J., Sivakumaran, K. (2022). 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. In European Heart Journal (Vol. 43, Issue 38, pp. 3618–3731). Oxford University Press. https://doi.org/10.1093/eurheartj/ehac237
Kazimierczyk, R., Malek, L. A., Szumowski, P., Nekolla, S. G., Blaszczak, P., Jurgilewicz, D., Hladunski, M., Sobkowicz, B., Mysliwiec, J., Grzywna, R., Musial, W. J., & Kaminski, K. A. (2021). Multimodal assessment of right ventricle overload-metabolic and clinical consequences in pulmonary arterial hypertension. Journal of Cardiovascular Magnetic Resonance, 23(1). https://doi.org/10.1186/s12968-021-00743-2
Krisdinarti, L., Hartopo, A. B., Anggrahini, D. W., Sadewa, A. H., Wahab, A. S., & Setianto, B. Y. (2016). Clinical characteristics of adult uncorrected secundum atrial septal defect: a pilot study. Journal of Thee Medical Sciences (Berkala Ilmu Kedokteran), 48(02), 89–97. https://doi.org/10.19106/jmedsci004802201603
Kurniawaty, J., & Baskoro, R. (2016). Penanganan Perioperatif Pasien dengan Atrial Septal Defect. Jurnal Komplikasi Anestesi, 3(2), 31–40. http://anestesi.fk.ugm.ac.id/jka.ugm/download-file-850062.pdf
Martin, S. S., Shapiro, E. P., & Mukherjee, M. (2015). Atrial septal defects – Clinical manifestations, echo assessment, and intervention. In Clinical Medicine Insights: Cardiology (Vol. 8, pp. 93–98). Libertas Academica Ltd. https://doi.org/10.4137/CMC.S15715
Munaiseche, K., Munayang, H., & Kaunang, E. D. (2016). Hubungan penyakit jantung bawaan pada anak dengan status pendidikan orang tua. E-CliniC, 4(2), 0–5. https://doi.org/10.35790/ecl.4.2.2016.13921
Putra, S. T., Djer, M. M., Idris, N. S., Samion, H., & Sastroasmoro, S. (2015). Transcatheter closure of atrial septal defects in a center with limited resources: Outcomes and shortterm follow-up. Iranian Journal of Pediatrics, 25(6). https://doi.org/10.5812/ijp.3906
Rampengan, S. H., & Rosmaningtyas, C. A. A. (2023). A patient with large ostium primum atrial septal defect who underwent open heart surgical closure with pericardial patch: a case report. Bali Medical Journal, 12(2), 1934–1939. https://doi.org/10.15562/bmj.v12i2.4223
Ren, X., Johns, R. A., & Gao, W. D. (2019). Right heart in pulmonary hypertension: from adaptation to failure. In Pulmonary Circulation (Vol. 9, Issue 3). SAGE Publications Ltd. https://doi.org/10.1177/2045894019845611
Rozqie, R., Satwiko, M. G., Anggrahini, D. W., Sadewa, A. H., Gunadi, Hartopo, A. B., Mumpuni, H., & Dinarti, L. K. (2022). NKX2-5 variants screening in patients with atrial septal defect in Indonesia. BMC Medical Genomics, 15(1). https://doi.org/10.1186/s12920-022-01242-8
Simonneau, G., Montani, D., Celermajer, D. S., Denton, C. P., Gatzoulis, M. A., Krowka, M., Williams, P. G., & Souza, R. (2019). Haemodynamic definitions and updated clinical classification of pulmonary hypertension. The European Respiratory Journal, 53(1). https://doi.org/10.1183/13993003.01913-2018
Taichman, D. B., Ornelas, J., Chung, L., Klinger, J. R., Lewis, S., Mandel, J., Palevsky, H. I., Rich, S., Sood, N., Rosenzweig, E. B., Trow, T. K., Yung, R., Elliott, C. G., & Badesch, D. B. (2014). Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report. Chest, 146(2), 449–475. https://doi.org/10.1378/chest.14-0793
Takaya, Y., Akagi, T., Sakamoto, I., Kanazawa, H., Nakazawa, G., Murakami, T., Yao, A., Nanasato, M., Saji, M., Hirokami, M., Fuku, Y., Hosokawa, S., Tada, N., Matsumoto, K., Imai, M., Nakagawa, K., & Ito, H. (2022). Efficacy of treat-and-repair strategy for atrial septal defect with pulmonary arterial hypertension. Heart, 108(5), 382–387. https://doi.org/10.1136/heartjnl-2021-319096
Webb, G., & Gatzoulis, M. A. (2006). Atrial septal defects in the adult: recent progress and overview. Circulation, 114(15), 1645–1653. https://doi.org/10.1161/CIRCULATIONAHA.105.592055
DOI: https://doi.org/10.33024/minh.v6i7.13212
Refbacks
- There are currently no refbacks.
Copyright (c) 2024 Malahayati International Journal of Nursing and Health Science
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.