Abstract

JACC

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TCTAP A-058 . Presentation

Presenter

Jue Seong Lee

Authors

Jue Seong Lee1, Gi-Beom Kim2, Sang Yoon Lee3, Mi Kyoung Song3, Hye Won Kwon3, Eun-Jung Bae4

Affiliation

Korea University Anam Hospital, Korea (Republic of)1, Seoul National University Children's Hospital, Korea (Republic of)2, Sejong General Hospital, Korea (Republic of)3, Seoul National University Hospital, Korea (Republic of)4
View Study Report
TCTAP A-058
Congenital Heart Disease (ASD, PDA, PFO, VSD)

The Effect of Diuretics in the Atrial Septal Defect Size Reduction in Childhood

Jue Seong Lee1, Gi-Beom Kim2, Sang Yoon Lee3, Mi Kyoung Song3, Hye Won Kwon3, Eun-Jung Bae4

Korea University Anam Hospital, Korea (Republic of)1, Seoul National University Children's Hospital, Korea (Republic of)2, Sejong General Hospital, Korea (Republic of)3, Seoul National University Hospital, Korea (Republic of)4

Background

While diuretics are sometimes used in atrial septal defect (ASD) treatment, their effect on ASD size reduction remains unclear. We aimed to evaluate the efficacy of diuretics in ASD size reduction in pediatric patients.

Methods

We retrospectively reviewed the medical records ofpatients with secundum ASD (size ≥10 mm), between 2005 and 2019. Patients weredivided into two groups based on the diuretic administration.

Results

Of the 73 enrolled patients, 40received diuretics. The initial age at ASD diagnosis (2.8±1.7 vs. 2.5±2.0 years, p=0.526) and follow-up duration (22.3±11.4 vs. 18.7±13.2 months, p=0.224) were not significantly different between the groups. Though not statistically significant, the ASD diameter at the initial diagnosis was larger in the diuretic group (13.7±2.0 vs. 13.5±3.4 mm, p=0.761) and the indexed ASD diameter was larger in the non-diuretic group (25.5±5.9 vs. 26.9±10.3 mm/m2,p=0.493). The ASD diameter significantly increased in the non-diuretic group during follow-up (0.0±2.9 vs. +2.6±2.0 mm, p<0.001). The indexed ASD diameter significantly decreased in the diuretic group during follow-up (−5.7±6.5 vs. +0.2±3.9 mm/m2p<0.001). In the multivariable analysis, diuretic use (odds ratio[OR] 0.120; p=0.001) was the only factor associated with ASD diameter decrease and the most powerful factor in indexed ASD diameter reduction (OR 0.078; p<0.001). Device closure was more frequently performed in the diuretic (75.0%) than in the non-diuretic group (39.4%).

Conclusion

Patients receiving diuretics are less likely to undergo surgery. Diuretics may enable the use of smaller ASD devices for transcatheter treatment through ASD size reduction.

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TCTAP 2021 Virtual Apr 12, 2021
It’s very well organized. Thanks for sharing!