Morphological variations of secundum‐type atrial septal defects: Feasibility for percutaneous closure using Amplatzer septal occluders

Abstract

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.

Recent Changes in Instructions for Use for the Amplatzer Atrial Septal Defect Occluder: How to Incorporate These Changes While Using Transesophageal Echocardiography or Intracardiac Echocardiography?

“…Based on the description of surgeons, the erosions occur in the anteriorsuperior region of the atrial wall, an area that corresponds to the aortic and the superior rim on echocardiography. Although the primary reason for erosion has been attributed to device over-sizing, there have been cases in which there was no apparent device oversizing, however device placement did result in erosion [8].More than 40 % of patients with ASD have an aortic rim \5 mm [11]. In a recent review of cases of erosions by St. Jude Medical (SJM), aortic rim deficiency was present in 88 % of the cases in which erosion occurred.…”

“…More than 40 % of patients with ASD have an aortic rim \5 mm [11]. In a recent review of cases of erosions by St. Jude Medical (SJM), aortic rim deficiency was present in 88 % of the cases in which erosion occurred.…”

Efetividade da prótese de Amplatzer™ para fechamento percutâneo do defeito do septo interatrial tipo Ostium Secundum

“…This guidance offers adequate visualization of the margins and safe deployment of the device as well as confirmation that the vital structures such as vena cavae, coronary sinus and aortic rim are not compressed. It has been often reported in medical literature that deficient rims are intimately related to the success of the procedure and adequate attachment of the device to the septum 24,25 . If the device is deployed without this critical evaluation the chance of incomplete defect occlusion or embolization of the prosthesis increases significantly.…”

Fast block flow tracking of atrial septal defects in 4D echocardiography

“…The dynamic nature of ASD is primarily determined by the cardiac cycle with a mean area change of 61% between end-diastolic and end-systolic (Maeno et al, 2000). The change in size is highly variable and present measurements show subjectivity (Handke et al, 2001;Maeno et al, 2000;Podnar et al, 2001). There is little to no correlation between the dynamic changes of ASD and its size, heart rate or age of patient.…”