Copyright © 1999 by the European Society of Cardiology.
Transcatheter closure of secundum atrial septal defects with the new self-centering Amplatzer Septal Occluder
Department of Pediatric Cardiology and Biomedical Engineering, Christian-Albrechts-University of Kiel, Kiel, Germany
revised September 28, 1998; accepted September 30, 1998
Abstract
Aims The study was set up to find out whether a new self-centering prosthesis for transcatheter closure of secundum atrial septal defects could overcome the disadvantages of previously described devices.
Methods and Results Fifty-two consecutive patients with a significant atrial septal defect were considered for trans-catheter closure with the Amplatzer Septal Occluder. The device, made of a Nitinol and polyester fabric mesh, provides a different approach to defect occlusion by stenting the atrial septal defect up to a stretched diameter of 26mm. Three infants whose large defects were demonstrated on a transthoracic echocardiogram were excluded from transcatheter treatment. On transoesophageal echocardiography, 49 defects ranged from 6–26mm, in one adult the defect measured 28mm and this patient was excluded from attempted transcatheter closure. At cardiac catheterization in five further patients, devices were not implanted, in two because the stretched diameter exceeded 26mm and in three the device was withdrawn because it was unstable or compromised the mitral valve. Thus, device closure was performed in 43 patients. At follow-up after 3 months the complete closure rate was 97%.
Conclusion The self-centering Amplatzer Septal Occluder is very efficient and user-friendly and offers interventional closure in 83% of an unselected group of patients presented with an atrial septal defect.
Key Words: Secundum atrial septal defect, congenital heart disease, interventional cardiology, transcatheter closure, self-centering Nitinol device, Amplatzer Septal Occluder
f1 Correspondence : Prof. Dr H. H. Kramer, Department of Pediatric Cardiology and Biomedical Engineering, Christian-Albrechts-University of Kiel, Schwanenweg 20, D-24105 Kiel, Germany.
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