Development and testing of the helex septal occluder, a new expanded polytetrafluoroethylene atrial septal defect occlusion system

Background-A variety of transcatheter atrial septal defect (ASD) occluders are currently in use around the world. Although for the most part effective , all of these devices lack features that would be desirable in a "perfect" device. The Helex septal occluder is a new type of device designed to impr ove the results of transcatheter ASD closure. This study was designed to ex amine the effectiveness and safety of this occluder in an animal model. Met hods and Results-The Helex was implanted into 24 dogs with surgically creat ed ASDs. Procedural details focusing on deployment, removal, and early clos ure rates were examined. Follow-up consisted of sequential transesophageal echocardiography and fluoroscopy as well as epicardial contrast echocardiog raphy and angiography at the time of death. Specimens were examined grossly and histologically, and devices were tested for metal fatigue. All animals had successful ASD closure. Implantation was uncomplicated (mean fluorosco py time 11.7 minutes), and removal or repositioning was always possible. Cl osure rate as judged by transesophageal echocardiography was 88% initially and 100% at 2-week follow-up. Devices rapidly became infiltrated with conne ctive tissue without inflammation and were endothelialized over time. There were no instances of thromboembolism. A single wire-frame fracture occurre d secondary to a prototype delivery system malfunction. Conclusions-The Helex septal occluder proved safe and effective for ASD clo sure. Several advantages over currently available devices were evident in t his model. Controlled prospective clinical trials are needed.