H. Sievert et al., TRANSCATHETER CLOSURE OF ATRIAL SEPTAL-DE FECT - EXPERIENCES WITH THERUSHKIND AND SIDERIS OCCLUSION SYSTEMS, Deutsche Medizinische Wochenschrift, 119(40), 1994, pp. 1341-1345
The possibility of closing an atrial septal defect in adults by means
of a percutaneously introduced catheter with an umbrella-type occluder
was tested in seven consecutive patients with this defect (two men an
d five women, aged 35 to 69 years). The diameter of the defect (echoca
rdiographic measurement) ranged from 7 to 25 mm, the left to right shu
nt from 11% to 54% of pulmonary flow and the pulmonary artery pressure
from 24/8 to 110/25 mmHg. In one patient no attempt was made to close
the defect because of its size (invasively measured: 40 mm). In anoth
er patient the method failed. Closure was successful in four of the pa
tients (left to right shunt < 5%), while in a fifth patient a haemodyn
amically significant residual shunt (38%) remained, but was closed 2 m
onths later with a second occluder. In one of the patients a portion o
f the device embolized to the pulmonary artery from which it was remov
ed by catheter. - Thus the intervention was successful in five of six
patients. This experience suggests that this type of occluder can also
be used successfully in adults.