Premium
Outcomes and alternative techniques for device closure of the large secundum atrial septal defect
Author(s) -
Varma Chetan,
Benson Lee N.,
Silversides Candice,
Yip J.,
Warr Matthew R.,
Webb Gary,
Siu Samuel C.,
McLaughlin Peter R.
Publication year - 2004
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.10700
Subject(s) - medicine , septum secundum , closure (psychology) , cardiology , heart septal defect , economics , market economy
Outcomes of device closure of large and small secundum atrial septal defects (ASDs) as related to rim anatomy with the Amplatzer atrial septal occluder were compared. Rim adequacy (≥ 5mm) of the anterior, inferior, posterior, and superior rims was determined using transesophageal echocardiography. Balloon‐stretched defect size defined patients into two groups: group 1, ≤ 25 mm (n = 138); group 2, > 25 mm (n = 34). Rim deficiency (n = 62) was more frequent in group 2 compared to group 1 (50% vs. 33%; P = 0.07), especially inferior rim deficiency (35% vs. 2%; P = 0.005). Device deployment was successful in group 1 and group 2 (100% vs. 91%; P = 0.007). Unsuccessful deployment was associated with an ASD of > 25 mm ( P = 0.007) and inferior rim deficiency ( P = 0.001). At first follow‐up (54 ± 16 days), right ventricular systolic pressure had improved in both groups ( P < 0.001). Closure of a large ASD associated with a lack of support in the inferior rim may warrant alternative strategies to position the device successfully. Catheter Cardiovasc Interv 2004;61:131–139. © 2004 Wiley‐Liss, Inc.