Transcatheter closure of secundum atrial septal defects using Amplatzer device.

OBJECTIVE: To evaluate the feasibility and short term results of transcatheter closure of secundum atrial septal defects (TCSASDs) using Amplatzer occluder device. A new self-centering device, the Amplatzer atrial septal occluder, has recently been evaluated in an animal model with excellent results. This paper reports our clinical research with this device.

METHODS: 30 patients underwent an attempt at TCSASDs at an average age of 35.6 +/- 15.9 y (range, 5-62 y) and average weight of 63.6 +/- 14.5 kg (range, 17-78 kg) using the Amplatzer atrial septal occluder. The average ASD diameter measured by transesophageal echocardiography (TEE) was 23.6 +/- 4.0 mm (range, 16-31 mm), and the average atrial septal defects (ASD) balloon stretched diameter was 25.2 +/- 5.8 mm (range, 9-34 mm). All patients had right atrial and ventricular volume overload with a Qp/Qs of 3.4 +/- 1.2 (1.4-5.2). A F8-12 catheter was used for delivery of the device in all patients.

RESULTS: The device was placed correctly in all patients. There was immediate and complete closure in 30 patients. The average device waist size used to close the defect was 25.6 +/- 5.9 mm (range, 9-34 mm). There was no episode of device embolization or any other complication. Follow-up was performed using transthoracic echocardiography (TTE) 1 day, 1 month, 3 months, 6 months and 1 year after the procedure. The first day after operation; there was complete closure of the ASD in all patients; there have been no episodes of endocarditis, thromboembolism, or wire fracture.

CONCLUSION: TCSASDs using the Amplatzer occluder device was an efficient nonsurgical method which had a very high technical success rate and satisfactory short term and follow-up results.