Outcomes and alternative techniques for device closure of the large secundum atrial septal defect

Catheter Cardiovasc Interv. 2004 Jan;61(1):131-9. doi: 10.1002/ccd.10700.

Abstract

Outcomes of device closure of large and small secundum atrial septal defects (ASDs) as related to rim anatomy with the Amplatzer atrial septal occluder were compared. Rim adequacy (> or = 5mm) of the anterior, inferior, posterior, and superior rims was determined using transesophageal echocardiography. Balloon-stretched defect size defined patients into two groups: group 1, < or = 25 mm (n = 138); group 2, > 25 mm (n = 34). Rim deficiency (n = 62) was more frequent in group 2 compared to group 1 (50% vs. 33%; P = 0.07), especially inferior rim deficiency (35% vs. 2%; P = 0.005). Device deployment was successful in group 1 and group 2 (100% vs. 91%; P = 0.007). Unsuccessful deployment was associated with an ASD of > 25 mm (P = 0.007) and inferior rim deficiency (P = 0.001). At first follow-up (54 +/- 16 days), right ventricular systolic pressure had improved in both groups (P < 0.001). Closure of a large ASD associated with a lack of support in the inferior rim may warrant alternative strategies to position the device successfully.

MeSH terms

  • Adult
  • Body Weights and Measures
  • Cardiac Catheterization / methods
  • Echocardiography, Transesophageal
  • Female
  • Heart Septal Defects, Atrial / diagnostic imaging
  • Heart Septal Defects, Atrial / therapy*
  • Humans
  • Male
  • Middle Aged
  • Prostheses and Implants
  • Prosthesis Implantation / methods*
  • Treatment Outcome