Author + information
- Alain Fraisse,
- Anass Assaidi,
- Issam Kammache,
- Julien Mancini,
- Phlippe Aldebert,
- Debora Luciano,
- Caroline Ovaert,
- Nicolas Michel and
- Gilbert Habib
We aimed to assess transcatheter closure for secundum atrial septal defect (ASD) with deficient rims(<5 mm), other than the anterior-superior since it is well demonstrated that deficiency in the rim toward the aorta does not influence the success rate for transcatheter closure.
Between January 1st, 2008 and october 31, 2012, 236 patients underwent percutaneous closure of ASD in our institution under transesophageal echocardiography guidance in children and intracardiac echocardiography in adults. We retrospectively analyzed the outcomes of the 48 patients(20%, 29 children) with one or more deficient rim other than the anterior-superior.
The median age and weight were 14(1.1-85) years and 35(8.8-99) Kg, respectively. The deficient rim was the inferior(toward the atrioventricular valves) in 11, the inferior- posterior(toward the inferior vena cava) in 18, the superior-posterior(toward the superior vena cava) in 18, and the posterior (toward the pulmonary veins) in 5 cases. Four out of 48 patients had multiple rim deficiency. Transcatheter closure was successfully performed in 42(87%) cases with a median Amplatzer Septal Occluder device size of 28(10 to 40) mm. A modified method of implantation(sizing balloon technique) was used in 39 patients(81%). In 6 patients(5 children) the ASD could not be closed. Four other children(8%) experienced device embolization few hours after transcatheter closure and underwent surgical ASD closure without further complication. By Fisher's exact test, deficiency of the inferior-posterior rim was associated with failure or embolization(P = 0.003) and there was a trend for children to be associated with embolization or failure(p= 0.065).
Transcatheter closure of secundum ASD is safe and effective in the majority of patients with deficient rims with the exception of inferior-posterior rim deficiency.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Congenital Cardiology Solutions: Percutaneous Therapies
Abstract Category: 14. Congenital Cardiology Solutions: Therapy
Presentation Number: 1204-134
- 2013 American College of Cardiology Foundation