Catheter Closure of Secundum ASD Using “Other” Devices

Abstract

The first nonoperative ASD closure was performed by Noel L. Mills and Terry D. King in a 17‐year old female patient on April 8, 1975. In the following years there was little interest in this clinical field after trials with the “Clamshell Device” had been discontinued because of arm fractures. From the late 1980s until the mid 1990s E. B. Sideris (“Buttoned Device”) and U.U. Babic (“ASDOS”) kept the ideas of King&Mills alive while G.S. Das developed the first self‐centering device (“AngelWings”). Clinical trials with ASDOS and AngelWings have been stopped because of complicated technology and risk of perforation. The Buttoned Device and its modifications are still used with high success rates even in defects >20 mm and low long‐term risk of perforation. Since the pioneering works of King & Mills marked improvements in devices and delivery systems have been achieved. After almost three decades of ongoing research and development, transcatheter ASD closure has become a clinical routine procedure. (J Interven Cardiol 2003;16:409–412)

Transcatheter closure of multiple interatrial communications

“…Nine occluder systems (Table ) were used, all of which have been described previously: Amplatzer (Amplatzer Septal Occluder, Amplatzer PFO Occluder, Amplatzer Cribriform Device) , CardioSEAL/STARFlex/BioSTAR devices , Helex , Figulla Occlutech , Premere , Coherex , PFO‐Star , ASDOS , and Angelwings .…”

Erosión muy tardía de la aurícula derecha con dispositivo Amplatzer®; reporte de un caso

“…El dispositivo Amplatzer ® está constituido por una malla de nitinol con material de poliéster insertados en 2 discos unidos por un cintura con alta flexibilidad 13 ; una vez implado está sometido a grandes fuerzas de deformación, y aunque no se ha reportado fractura por fatiga, se especula que estas fuerzas son directamente transmitidas a los tejidos generando erosión 14 . Si bien el tamaño del Amplatzer ® no predice el sitio de perforación, las paredes auriculares anterosuperiores y/o la aorta adyacentes son especialmente vulnerables al estrés generado por estos dispositivos y frecuentemente se han reportado con el área de trauma 15 . Las complicaciones que frecuentemente conducen a cirugía relacionadas con los aspectos técnicos durante el cateterismo se producen en la fase periprocedimiento o muy temprano antes del alta; no obstante, un tercio de estas pueden tener una presentación tardía, de semanas a años.…”

Surgical treatment of a left atrial rupture during transcatheter atrial septal defect closure: a case study

“…Cardiac perforation is a rare complication seen during percutaneous closure, with an incidence ranging from 0.1-0.4% depending on the instruments used. [7,8] The mortality rate associated with this complication is very high.…”