Echocardiographic characteristics of successful deployment of the Das AngelWings atrial septal defect closure device: Initial multicenter experience in the United States

AngelWings device is a newer transcatheter device used for closure of secun dum atrial septal defects (ASD) and patent foramen ovale (PFO), which consi sts of a self-centering, 2-disk system. Transesophageal echocardiography (T EE) plays a pivotal role in the deployment of the 2 disks of this device, o n the appropriate sides of the atrial septum. The objective of this study i s to describe the echocardiographic findings associated with successful dep loyment of the AngelWings device for closure of ASD and PFO. We evaluated t he TEE studies of 70 patients enrolled in 4 United States centers, for clos ure of ASD and PFO with the AngelWings device. The TEE characteristics of s uccessful and unsuccessful deployments were analyzed. Residual shunts acros s the atrial septum were assessed by TEE at the end of the procedure, 24 ho urs later by transthoracic echocardiography, and at 6 months by TEE. The de ployment of the device was successful in 65 patients (93%), In the unsucces sful group, ASD size by TEE was larger (13.4 +/- 3.1 vs 8.9 +/- 4.7 mmr, p <0.05). TEE was successful in identifying snagging of the device by intraca rdiac structures and prolapse of corners of the left or right atrial disk t hrough the ASD, features that were difficult to identify by fluoroscopy. Th e echocardiographic characteristics outlined here are important guidelines for successful deployment of the AngelWings device. (C) 1999 by Excerpta Me dica, Inc.