Percutaneous closure of ostium secundum atrial septal defects by the Amplatz device: a preliminary study of 29 patients.

The aim of the study was to assess the results of percutaneous closure of o stium secundum atrial septal defects (ASD) by the Amplatz device and to com pare them with those obtained by other methods. Over a one year period, closure of ASD was performed in 28 patients aged 7 to 66 years (mean of 32 years) with exclusive left-to-right shunts. The sel ection of patients was made by transthoracic echocardiography. Cardiac cath eterisation was performed to measure the stretched diameter of the defect. After patient or parental consent, the procedure was performed under genera l anaesthesia. The implantation was performed under transoesophageal echoca rdiographic control. The diameter of the Amplatz device corresponded to the stretched diameter of the ASD. The patients were discharged from hospital 48 hours later under platelet antiaggregant therapy for 6 months. Clinical, electrocardiographic, radiological and echocardiographic examinations were performed at 1 month, 3 months and 1 year after implantation. The stretched diameter was 12-27 mm (mean 22 mm). The device was withdrawn in one case because of a double ASD and, in another patient, failure was du e to embolisation of the obturator to the pulmonary artery before its impla ntation. The closure was complete in 21 of the 26 cases immediately after t he procedure; at one month, two residual shunts were observed but they had disappeared at 3 months and at 1 year. Out of 46 ASD closed by the Sideris button prosthesis, occlusion was total in 29 cases and partial in 17 cases. The authors conclude that the Amplatz device is an effective prosthesis for closure of ostium secundum ASD. With strict selection procedures, the resu lts are excellent.