Conventional Median Sternotomy Compared to the Percutaneous Transcatheter Device Closure for Secundum Atrial Septal Defect

Introduction: During the last decades, the percutaneous transcatheter device (PTD) closure for secundum atrial septal defect (ASD) has acquired significant popularity over the conventional median sternotomy (CMS). CMS is the classic approach for ASD closure. The major objective of this study was to determine whether ASD procedure or CMS surgical closure offers a better value proposition for ASD closure. Method: A total of 187 patients have been admitted for closure of the secundum ASD either by CMS or PTD in The Second Affiliated Hospital of Hainan Medical University from January 2017 to April 2021. We divided in to two group CMS group (n = 97) and the PTD group (n = 90). In CMS group, we excluded 12 patients, and in PTD group, we excluded 3 patients, we remained with 172 patients. Results: In PTD group out of the 87 patients who underwent device closure, 3 (3.44%) of the patients had operations failures and have been done by CMS. In the CMS group the 85 patients. The index data on the duration of the operation, the infused blood products, the duration in intensive care unit, the postoperative hospital length stay, and the morbidity were better in PTD group than in the CMS group. The difference between the two groups was statistically significant (P < 0.05). Conclusion: Both CMS and PTD for ASD are safe, feasible, and effective. PTD has more advantages in shorter duration of operation procedure, no requirement of blood products transfusion, no thoracotomy, better cosmetic effect, shorter duration in ICU, less morbidity and shorter hospital length of stay. PTD is the better choice for patients if the patients meet most of the appropriate conditions. CMS closure is still the basic operation also as an alternative in PTD failure or contraindication.