Transcatheter closure of secundum atrial septal defects using the new self-centering amplatzer septal occluder: Initial human experience

Mašura, Jozef; Gavora, Pavol; Formanek, A; Hijazi, Ziyad M.

doi:10.1002/(sici)1097-0304(199712)42:4<388::aid-ccd7>3.0.co;2-7

Cited by 384 publications

(240 citation statements)

References 8 publications

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“…The first clinical trial with the Amplatzer septal occluder was published in 1997. 5 Since then, many clinical studies with early follow-up results have been reported after ASD closure with the Amplatzer occluder. At present, transcatheter closure of the ASD is widely practiced and has replaced surgical ASD closure in many centers.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficiency and Safety Analysis of Transcatheter Closure of Multiple Atrial Septal Defects in Adults

Zhang

Maoqin

et al. 2009

Clinical Cardiology

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Background: Transcatheter closure of atrial septal defects (ASDs) is currently a reliable alternative to surgery, even though challenging in patients with multiple ASDs. Hypothesis: The aim of this study was to evaluate the clinical efficiency and safety of transcatheter closure in multiple ASDs. Methods: Multiple ASDs were diagnosed by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The occlusive condition and distance between 2 adjacent ASDs were measured by TTE examination. Then, the number and size of the occluder(s) was determined. TTE examinations were performed after transcatheter closure as follow-up. Results: The transcatheter procedure was successful in 15 patients with multiple ASDs, using a single occluder in 9 patients and 2 occluders in the remaining 6 patients. Overall, 21 ASD occluders were implanted. During a follow-up period of 6 mo to 5 y, a slight residual shunt was found in 1 patient without any symptoms; a moderate residual shunt was identified at the inferior vena cava and the occluder was removed by surgery 1 mo after procedure. Other complications, including endocarditis, arrhythmia, thromboembolism, and atrioventricular valve damage were not recorded in any of the 15 patients during the follow-up period. Conclusion: Transcatheter closure of multiple ASDs is safe and efficient. Two occluders are necessary for the distance of 2 ASDs more than 7 mm, and a single occluder is sufficient for those 7 mm or less.

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Section: Introductionmentioning

confidence: 99%

Clinical Efficiency and Safety Analysis of Transcatheter Closure of Multiple Atrial Septal Defects in Adults

Zhang

Maoqin

et al. 2009

Clinical Cardiology

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“…ASD device closure stills the treatment of choice for the selected patient without major complications [1,3]. Rhythm disturbance is one of the uncommon complication might be occur after days or weeks from the implantation of large device in small children necessitating a close follow up for those patient with frequent ECGs and holter monitor and most likely has a good prognosis with spontaneous recovery to sinus rhythm in the majority of the cases.…”

Section: Resultsmentioning

confidence: 99%

“…Transcatheter Device closure for secundum ASD is the treatment of choice when the patient has a good rims [1,2] and it has an excellent shore and long term results with minimal complications [3,4]. Rhythm disturbance is one of these uncommon complications [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Heart Block After ASD Device Closure

Alsoufi¹

2014

JCCR

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4 years old boy with weight of 10.5 Kg and height of 100 cm, he is known case of moderate to large ASD secondum with recurrent chest infections and failure to thrive under treatment with frosimed and close follow up in the clinic. Cardiovascular examination reviled: normal S1+fixed and splitting of S2+ejection systolic murmur at left upper sternal border, per-procedure electrocardiogram showed normal sinus rhythm with heart rate 95-100/min ,incomplete right bundle brunch block. His echocardiography reviled large ASD secondum of 15-16 mm with adequate SVC, IVC and aortic rims and slightly short AV valve rim associated with dilated right atrium and ventricle with sings of increased pulmonary blood flow. During cardiac catheterization under general anesthesia and transesophaygeal echocardiography guidance we confirmed the accurate size of the defect and decided to precede and close this ASD by 18 mm Amplatzer septal occluder (the device/height ratio is : 0.18 )The procedure went smoothly without any complications in the cath lab and the patient was observed in the recovery area then in PICU with stable vital sings, sinus rhythm around 99-101/ min and after 24 h of the closure electrocardiography showed normal sinus rhythm with same degree of PRBBB ( Figure 1). Echocardiography showed big ASD device insite without any residual shunt or interacting with adjacent structures ( Figure Heart Block After ASD Device Closure 2).Patient was discharged home on aspirin 50 mg daily and given appointment after one week for follow up in the clinic. After one week he came to pediatric cardiology for follow up, he was asymptomatic with no complain, his heart rate was 66/min with regular rhythm, other vital signs were stable. Echocardiography at that time showed ASD device in good position without any residual shunt or interfering with A-V valves or other structures. His ECG showed dominant sinus rhythm with HR = 66/min , prolonged PR interval l0.18 -0.2 sec (first degree heart block) and occasional 2:1 heart block ( Figure 3). 24 hour holter monitor also confirm the finding of first degree heart block with occasional second degree as 2:1 but no escape rhythm or long pauses. The parents refused the admission for observation and they preferred to come daily for close follow up so we started him on oral prednisolone 1 mg/kg/day with ECG monitoring every 2 days. After 5 days from this plan the patient remain stable with no complain but his ECG showed normal sinus rhythm with shorter PR interval 0.16 -0.17 sec and no signs of heart block (recovered normal sinus rhythm) (Figure 4). 24 hour holter monitor also confirm the normal sinus rhythm without any arrhythmias so we stopped the prednisolone and kept him under observation every week with new ECG.After one month he was stable,no complains and started to gain some weight on aspirin only.ECG at that time showed normal sinus rhythm with normal PR interval 0.16 sec and no signs of heart block ( Figure 5). Echocardography revealed the device inn place, no residual shunt, no interfering wi...

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“…Devices were deployed as previously described. 23,27 Intravenous heparin (100 U/kg) was given during the procedure, followed by 1 month of clopidogrel 75 mg daily and 6 months of aspirin 75 mg daily. Transthoracic echocardiography was performed at 24 h, and 1, 3, and 6 months post implantation.…”

Section: Techniquementioning

confidence: 99%

“…11 Transcatheter closure of ASDs is increasingly used in adults. 8,9,[12][13][14][15][16][17][18][19][20][21][22][23][24] The Amplatzer occluder is a second generation self-centering device which is a widely accepted treatment for ASD and PFO. 18,19 Clinical experience with the Amplatzer devices is relatively limited in adults, particularly in those with large defects (> 26 mm in diameter), which are uncommon in published series.…”

Section: Introductionmentioning

confidence: 99%

Closure of defects of the atrial septum in adults using the amplatzer device:100 consecutive patients in a single center

Purcell

Brecker

Ward

2004

Clinical Cardiology

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SummaryBackground: Transcatheter device closure of atrial septal defects (ASD) is an alternative to surgery, but experience is limited in adults, especially in those with large (> 26 mm) defects.Hypothesis: We investigated the safety, efficacy, and learning curve for closure of ASD and patent foramen ovale (PFO) using the Amplatzer device.Methods: In all, 101 procedures were carried out in 100 consecutive adult patients in a single cardiac center between July 1998 and August 2002.Results: Preprocedure diagnosis was ASD and PFO in 50 patients each. A device was deployed in 94 of 101 attempts (93%) in 94 of 100 patients (94%). Atrial septal defect device sizes were 10-38 mm, median 24 mm, and 40% were > 26 mm. Major complications occurred in 2 of 100 patients (2%). One ASD device displaced requiring surgery within 24 h and one patient with PFO experienced pericardial tamponade; there were no deaths. Local vascular complications occurred in 4 of 100 (4%) and late complications in 4 of 100 (4%) patients. Patent foramen ovale closure was quicker (p < 0.001), required less radiation (p = 0.04), and was associated with fewer local vascular complications than ASD closure (p = 0.04). Deployment of ASD devices > 26 mm was not associated with increased complications, length of procedure, or radiation compared with devices ≤ 26 mm (all p > 0.05). Complications in the first 35 patients were more frequent than in subsequent patients: 7 of 35 (20%) versus 3 of 65 (4.6%) (p = 0.04); proce-

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Transcatheter closure of secundum atrial septal defects using the new self-centering amplatzer septal occluder: Initial human experience

Cited by 384 publications

References 8 publications

Clinical Efficiency and Safety Analysis of Transcatheter Closure of Multiple Atrial Septal Defects in Adults

Clinical Efficiency and Safety Analysis of Transcatheter Closure of Multiple Atrial Septal Defects in Adults

Heart Block After ASD Device Closure

Closure of defects of the atrial septum in adults using the amplatzer device:100 consecutive patients in a single center

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