Contreras, Alejandro E.Ledesma, FacundoPeirone, Alejandro R.Juaneda, ErnestoDefago, VictorCuestas, Eduardo2023-07-212023-07-212023-04Contreras Alejandro E., Ledesma Facundo, Peirone Alejandro R., Juaneda Ernesto, Defago Victor, Cuestas Eduardo. Sufficient versus deficient rims during percutaneous closure of ostium secundum type atrial septal defect: A systematic review and meta-analysis. Indian Heart Journal. 2023 Apr; 75(2): 145-1520019-48322213-3763http://imsear.searo.who.int/handle/123456789/220974Background: The aim of this meta-analysis was to compare the efficacy and adverse events of percutaneous occlusion among patients with sufficient and deficient rims. Methods: A systematic review of all articles published in the Pubmed, MEDLINE and Google Scholar databases was performed. Odds ratio (OR) and 95% CI were used as a measure of effect of the combination of studies. I2 with 95% CI was estimated to assess study heterogeneity. For the meta-analysis, a random effects model was used. Results: The systematic search identified ten studies which included 4355 patients; 2661 of those had sufficient rim and the remaining 1694 patients showed some rim deficiency. Implant failure rate was 4.13% CI 95% 3.53e4.72%. Compared to frequency of failures in the group with a deficient rim (5.43% CI 95% 4.35e6.50%), implant failure in patients with a sufficient rim was significantly lower (3.30% CI 95% 2.62e3.97%), OR 2.27 CI 1.34e3.83 (p 0.002). The combined adverse events were 5.19% CI 95% 4.22e6.35% vs 2.7% CI 95% 2.08e3.31% in the deficient vs sufficient rim groups respectively (OR 2.21 CI 0.93e5.29; p 0.07). Implant failures and adverse events were more frequent in patients with posterior inferior rim deficiency. Conclusion: Patients presenting a posteroinferior rim deficiency are associated to both, an increased incidence of closure failure and a combined adverse events occurrence. More studies on posterior rim deficiency are necessary to ensure the feasibility and safety of the percutaneous approach.Atrial septal defectEfficacyAdverse eventsEchocardiographyJournal ArticleIndiaDepartment of Cardiology, Hospital Privado Universitario de Cordoba/Instituto Universitario de Ciencias Biomedicas de Cordoba, Cordoba, ArgentinaDepartment of Pediatrics, Hospital Privado Universitario de Cordoba, Cordoba, ArgentinaDepartment of Pediatric Cardiology, Hospital Privado Universitario de Cordoba, Cordoba, Argentina