Author + information
- Received May 16, 1997
- Revision received December 4, 1997
- Accepted December 30, 1997
- Published online April 1, 1998.
- Basil (Vasilios) D Thanopoulos MDA,*,
- Cleo V Laskari MDA,
- George S Tsaousis MDA,
- Armine Zarayelyan MDA,
- Athina Vekiou MDA and
- George S Papadopoulos MDA
- ↵*Dr. Basil (Vasilios) D. Thanopoulos, Department of Pediatric Cardiology, Aghia Sophia Children’s Hospital, Thivon and Levadias Street, Athens, Greece 11527.
Objectives. This study reports our clinical experience with transcatheter closure of secundum atrial septal defects (ASDs) in children, using the Amplatzer, a new occlusion device.
Background. None of the devices previously used for transcatheter closure of interatrial communications has gained wide acceptance.
Methods. We examined the efficacy and safety of the Amplatzer, a new self-centering septal occluder that consists of two round disks made of Nitinol wire mesh and linked together by a short connecting waist. Sixteen patients with secundum ASD met established two- and three-dimensional echocardiographic and cardiac catheterization criteria for transcatheter closure. The Amplatzer’s size was chosen to be equal to or 1 mm less than the stretched diameter. The device was advanced transvenously into a 7F long guiding sheath and deployed under fluoroscopic and ultrasound guidance. Once its position was optimal, it was released.
Results. The mean ASD diameter by transesophageal echocardiography was 14.1 ± 2.3 mm and was significantly smaller (p < 0.001) than the stretched diameter of the ASD (16.8 ± 2.4 mm). The mean device diameter was 16.6 ± 2.3 mm. No complications were observed. After deployment of the prosthesis, there was no residual shunt in 13 (81.3%) of 16 patients. In three patients there was trivial residual shunt immediately after the procedure that had disappeared in two of them at the 3-month follow-up.
Conclusions. The Amplatzer is an efficient prosthesis that can be safely applied in children with secundum ASD. However, a study including a large number of patients and a longer follow-up period are required before this technique can be widely used.
- Received May 16, 1997.
- Revision received December 4, 1997.
- Accepted December 30, 1997.
- The American College of Cardiology