Transcatheter occlusion of secundum atrial septal defects with the self-centering Amplatzer Septal Occluder

A new approach to transcatheter occlusion of secundum atrial septal defects uses the self-centering and repositionable 'Amplatzer Septal Occluder'. Th is report presents our initial clinical experiences with this device, made from a 0.005-inch Nitinol mesh and polyester fabric. During a 2-year period , 98 patients (median age 6.3 years, range 1-43 years, median weight 22 kg, range 10-82 kg) with secundum atrial septal defects were evaluated for tra nscatheter closure of the defect using the Amplatzer Septal Occluder. The d iameters of the defects measured by transesophageal echocardiography ranged from 5 to 23 mm (median 12 mm) and the stretched diameters measured by bal loon catheter ranged from 7 to 28 mm (median 15 mm). Established criteria f or interventional treatment were met in 98 patients and defect implantation was successful in 88 of them (89.8%). Median fluoroscopy time was 15 min ( range 7-64 min) and the total procedure time was 90 min (range 55-16 min). After 24 h, colorflow Doppler examination showed complete defect closure in 72 of the 88 (82%) patients. Complete closure was demonstrated in 55 (96.5 %) of 57 patients followed for at least 3 months after implantation. In all 10 patients followed for more than 1 year, no residual shunts were found. No clinical complication, fracture of the device wires, or embolization of the device has occurred. Published by Elsevier Science Ireland Ltd.