Transcatheter closure of atrial septal defect using Amplatzer septal occluder in Chinese adults

Abstract

Amplatzer septal occluder (AGA Med. Co., USA) is a novel device for occlusion of atrial septal defect. We present our experience of transcatheter closure of atrial septal defects using Amplatzer septal occluder in 45 adult Chinese patients (age range 18-69 years). The size of atrial septal defect varied from 14-28 (23 +/- 4) mm. Cardiac catheterization revealed a pulmonary-to-systemic shunt ratio ranging from 1.4-2.8 (mean 2.0 +/- 0.4). The procedure was successful in 44 (98%) patients. Displacement of the device requiring surgical removal occurred in one (2%) patient and minor wound complication occurred in two (4%) patients. Total procedure time was 67 +/- 16 minutes and the fluoroscopy time was 25 +/- 8 min. Immediate post-procedure and pre-discharge echocardiography revealed complete abolition of shunt in 42 (93%) and trivial residual shunt in 3 (7%) patients. The average follow-up period was 16 +/- 6 months (range 2 months to 3 years) months. None of the patients had developed other major complication at follow-up. Cathet Cardiovasc Intervent 2001;52:373-377.

Recent experience on atrial septal defect device closure at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

“…Thus avoiding subsequent surgical scar and postoperative pain. 4,6,7 The other advantages are less psychological impact, shorter hospital stay, and less need for blood transfusion. 5,7 The absence of myocardial scar may decrease the incidence of incisional dysrhythmias.…”

“…4,6,7 The other advantages are less psychological impact, shorter hospital stay, and less need for blood transfusion. 5,7 The absence of myocardial scar may decrease the incidence of incisional dysrhythmias. 7 Device implantation success rate of 98.4% is comparable to studies around the world where the success rate of device closure remained between 94-99%.…”

Reply to the letter to the editor by Lee et al.

“…Indeed, transesophageal echocardiographic and fluoroscopic confirmation of the device position gives no cue to the security of the device position. We recently experienced a patient who after initial confirmation of the device position was found to have migration of the device at 1 month after the procedure [3]. Therefore, despite apparently successful repositioning of the device by snaring the microscrew, we would recommend elective surgical removal of the device together with simultaneous direct surgical closure of the atrial septal defect during the operation.…”

Transcatheter closure of the atrial septum: It's been a long strange trip

“…As the article from Lee et al [6] and several other registries have demonstrated, this modality is safe and can be applied to a wide variety of ASD patients with significant comorbidites. In the case of PFO, recurrent thromboembolism is low at 5 years and may be negligible after 2 years [1].…”

“…In this issue, Lee et al [6] report their experience with the Amplatzer septal occluder in a tertiary-care center in Hong Kong. The procedure time was relatively short (67 min on average) and the complication rate was low (2%) in a total of 45 cases.…”