Since the first human implantations in September 1995, the Amplatzer septal occluder proved as a safe and effective device for percutaneous closure of ASD II.
The aim of the study was to assess the morphology of secundum-type atrial septal defects (ASD) with a view to percutaneous closure using Amplatzer septal occluders (ASO). One hundred and ninety patients who underwent closure of isolated secundum-type ASD between September 1995 and January 2000 were included. The morphology of the defects was studied using transthoracic and transesophageal echocardiography. Patients with defects of suitable morphology and size underwent percutaneous closure using ASO. The remaining patients underwent surgical closure. Centrally placed defects were observed in 46 patients (24.2%). Morphological variations of secundum-type ASD were detected in 144 patients (75.8%). One hundred and fifty-one patients (79.5%) underwent percutaneous closure using ASO. Thirty-nine patients (20.5%) underwent surgical closure. Centrally placed defects, defects with deficient superior anterior rim, multiple defects, and perforated aneurysms of the interatrial septum are morphological variations of secundum-type ASD suitable for percutaneous closure using ASO. Cathet Cardiovasc Intervent 2001;53:386-391.
It appears that the role of PFO in ischemic cerebrovascular event of unknown cause in children may be underestimated. Contrast TCD with VM is a sensitive, noninvasive method for PFO detection, proved in our experience particularly suitable for children. In children with unexplained ischemic cerebrovascular event and presumed paradoxical embolism, percutaneous PFO closure should be considered.
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