Simultaneous Endovascular ASD Closure and Coronary Stenting in Adults: Short-term and Long-term Follow-up

Dzhamil Asadov, David Iosseliani, Ilya Kovalchuk, Dmitrii Kurtasov, Anna Rogatova

Moscow City center for interventional cardioangiology, Moscow, Russia

Date, time and location: 2018.05.26 15:30, Congress Hall, 2F–A

Abstract

Purpose: to evaluate clinical effectiveness and reasonability of simultaneous coronary stenting and ASD closure.

Material and methods: 6 patients had simultaneous endovascular ASD-II closure and coronary stenting. The average age of these patients was 63 ±6,4 years.

All patients have had angina pectotis. The average size of ASD (according to TEE) was 13,7 ±3,1 mm. Mean Syntax Score was 14,5 ±4,9. The average number of stents was 2,0 ±1,0 per patient.

Results: Coronary stenting was performed during the first stage, followed by ASD closure. Procedures were technically successful in 100%. The average occluder’s diameter was 21±7,3 mm. Immediately after the implantation complete ASD closure was noticed in 5 cases. One patient had insignificant (residual) shunt. Coronary stenting was performed in all cases without complications. Early in-hospital follow-up was uneventful. At control examination (13,5±1,5 months) the defects were completely occluded in all patients. There were no late complications. In all cases the right heart volumes were significantly decreased. According to TEE data, the RA volume decreased from 48,6±5,6 to 32,6±3,8 cm3, the RV volume – from 45,2±5,1 to 33,4±3,8 cm3, the mean PAP decreased from 49,7 ±8,6 to 32,6±6,9 mm Hg. Clinical signs of the defect seen before, disappeared completely in all patients. Control CAG revealed preserved good results of PCI.

Conclusion: Simultaneous combined coronary stenting and endovascular ASD closure is a safe and effective procedure. This strategy and the sequence of interventions is hemodynamically reasonable, clinically justified, not associated with any risks for the patients and contributes to the shortening of in-hospital stay.