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Transcatheter closure of very large (≥ 25 mm) atrial septal defects using the Amplatzer septal occluder
Author(s) -
Kannan Bhava Ramalingam Jawahar,
Francis Edwin,
Sivakumar Kothandam,
Anil Sivadasan Radha,
Kumar Raman Krishna
Publication year - 2003
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10575
Subject(s) - medicine , fluoroscopy , shunt (medical) , atrial flutter , surgery , embolization , catheter , heart septal defect , cardiology , cardiac catheterization , atrial fibrillation
Between June 1999 and September 2002, 45 patients (age, 34 ± 13 years; mean shunt ratio, 2.6 ± 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.4 ± 3 mm). Patients were selected by transesophageal echocardiography. The mean ASD dimension was 25.3 ± 3.7 mm and 33 (73%) patients had deficient anterior rim. Specific procedural details included the use of 13 or 14 Fr introducer sheaths and the right upper pulmonary vein approach if the conventional approach failed. There were two procedural failures, with device embolization in both (surgical retrieval in one, catheter retrieval in one). During follow‐up (3–30 months; median, 16 months), one patient (59 years) with previous atrial flutter had pulmonary embolism and was managed with anticoagulation. Two patients developed symptomatic atrial flutter. Fluoroscopy time was 31.6 ± 19.5 min for the first 22 cases and 19.6 ± 11.4 min for the rest ( P = 0.04). Transcatheter closure of large ASDs is technically feasible but careful long‐term follow‐up is needed to document its safety. Cathet Cardiovasc Intervent 2003;59:522–527. © 2003 Wiley‐Liss, Inc.