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Wann LS Curtis AB January CT Ellenbogen KA Lowe JE Estes NA Page RL Ezekowitz MD Slotwiner DJ Jackman WM Stevenson WG Tracy CM Fuster V Rydén LE Cannom DS Le Heuzey JY Crijns HJ Lowe JE Curtis AB Olsson SB Ellenbogen KA Prystowsky EN Halperin JL Tamargo JL Kay GN Wann LS Jacobs AK Anderson JL Albert N Hochman JS Buller CE Kushner FG Creager MA Ohman EM Ettinger SM Stevenson WG Guyton RA Tarkington LG Halperin JL Yancy CW;ACCF/AHA/HRS 《Journal of the American College of Cardiology》2011,57(2):223-242
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Karen K. Stout Curt J. Daniels Jamil A. Aboulhosn Biykem Bozkurt Craig S. Broberg Jack M. Colman Stephen R. Crumb Joseph A. Dearani Stephanie Fuller Michelle Gurvitz Paul Khairy Michael J. Landzberg Arwa Saidi Anne Marie Valente George F. Van Hare 《Journal of the American College of Cardiology》2019,73(12):e81-e192
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Sana M. Al-Khatib William G. Stevenson Michael J. Ackerman William J. Bryant David J. Callans Anne B. Curtis Barbara J. Deal Timm Dickfeld Michael E. Field Gregg C. Fonarow Anne M. Gillis Christopher B. Granger Stephen C. Hammill Mark A. Hlatky José A. Joglar G. Neal Kay Daniel D. Matlock Robert J. Myerburg Richard L. Page 《Heart rhythm》2018,15(10):e73-e189
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Sana M. Al-Khatib William G. Stevenson Michael J. Ackerman William J. Bryant David J. Callans Anne B. Curtis Barbara J. Deal Timm Dickfeld Michael E. Field Gregg C. Fonarow Anne M. Gillis Christopher B. Granger Stephen C. Hammill Mark A. Hlatky José A. Joglar G. Neal Kay Daniel D. Matlock Robert J. Myerburg Richard L. Page 《Heart rhythm》2018,15(10):e190-e252
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Matthew Oster Ami B. Bhatt Elisa Zaragoza-Macias Nandini Dendukuri Ariane Marelli 《Journal of the American College of Cardiology》2019,73(12):1579-1595
Secundum atrial septal defect (ASD) is the most common adult congenital heart defect and can present with wide variation in clinical findings. With the intention of preventing morbidity and mortality associated with late presentation of ASD, consensus guidelines have recommended surgical or percutaneous ASD closure in adults with right heart enlargement, with or without symptoms. The aim of the present analysis was to determine if the protective effect of secundum ASD closure in adults could be qualified by pooling data from published studies.A systematic review and meta-analysis were performed by using EMBASE, MEDLINE (through PubMed), and the Cochrane Library databases to assess the effect of secundum ASD percutaneous or surgical closure in unoperated adults ≥18 years of age. Data were pooled across studies with the DerSimonian-Laird random-effects model or a Bayesian meta-analysis model. Between-study heterogeneity was assessed with Cochran’s Q test. Bias assessment was performed with the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool, and statistical risk of bias was assessed with Begg and Mazumdar’s test and Egger’s test.A total of 11 nonrandomized studies met the inclusion criteria, contributing 603 patients. Pooled analysis showed a protective effect of ASD closure on New York Heart Association functional class and on right ventricular systolic pressure, volumes, and dimensions. Two additional studies comprising 652 patients were reviewed separately for mortality outcome and primary outcome of interest because they did not meet the inclusion criteria. Those studies showed that ASD closure was associated with a weak protective effect on adjusted mortality rate but no significant impact on atrial arrhythmias in patients >50 years of age. Across all studies, there was significant heterogeneity between studies for nearly all clinical outcomes. The overall body of evidence was limited to observational cohort studies, the limitations of which make for low-strength evidence. Even within the parameters of the included studies, quality of evidence was further diminished by the lack of well-defined clinical outcomes.In conclusion, pooled data analysis on the impact of secundum ASD closure in adults was notably limited because of the lack of randomized controlled trials in patients with only secundum ASD. The few cohort studies in this population demonstrated improvement in functional status and right ventricular size and function as shown by echocardiogram. However, our findings suggest that at the time of this publication, insufficient data are available to determine the impact of ASD repair on mortality rate in adults. 相似文献
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Wann LS Curtis AB January CT Ellenbogen KA Lowe JE Estes NA Page RL Ezekowitz MD Slotwiner DJ Jackman WM Stevenson WG Tracy CM; Writing Group Members Fuster V Rydén LE Cannom DS Le Heuzey JY Crijns HJ Lowe JE Curtis AB Olsson S Ellenbogen KA Prystowsky EN Halperin JL Tamargo JL Kay GN Wann L; Writing Committee Members Jacobs AK Anderson JL Albert N Hochman JS Buller CE Kushner FG Creager MA Ohman EM Ettinger SM Stevenson WG Guyton RA Tarkington LG Halperin JL 《Circulation》2011,123(1):104-123
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《Journal of the American College of Cardiology》2020,75(16):1975-2088
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Robert O. Bonow Frederick A. MasoudiJohn S. Rumsfeld MD PhD FACC FAHA Elizabeth DeLongN.A. Mark Estes III MD FACC FAHA David C. Goff JrKathleen Grady PhD RN FAHA FAAN Lee A. GreenAnn R. Loth RN MS CNS Eric D. PetersonIleana L. Piña MD FACC Martha J. RadfordDavid M. Shahian MD FACC 《Journal of the American College of Cardiology》2008