Premium
Novel delivery technique for atrial septal defect closure in young children utilizing the GORE ® CARDIOFORM ® septal occluder
Author(s) -
Anderson Jason H.,
Fraint Hannah,
Moore Phillip,
Cabalka Allison K.,
Taggart Nathaniel W.
Publication year - 2017
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.26874
Subject(s) - septum secundum , medicine , percutaneous , shunt (medical) , closure (psychology) , surgery , cardiac catheterization , economics , market economy
Objectives To develop a novel delivery technique to overcome vascular size limitations for device closure of a secundum ASD in the young patient. Background The efficacy, clinical utility, and safety of transcatheter closure in comparison to surgical closure are well established; however, access vessel size remains a potential limitation to device selection in the young patient. Methods A retrospective medical record review of all cases of secundum ASD closure between April 2015 and April 2016 utilizing a novel delivery method described herein at two separate academic institutions. The device is disassembled allowing the delivery sheath to serve as the introducer. It is advanced to the RA with re‐introduction of the device allowing for deployment in the standard fashion. Results Overall, 10 patients underwent secundum ASD closure via this novel delivery technique. There were six females (60%) and the average age at time of the procedure was 4.2 years ± 1.6 years (range 2–6 years). The majority of patients had an isolated secundum ASD (70%) with the primary indication for closure being right ventricular volume overload (90%). All patients had successful placement of a GORE ® CARDIOFORM ® Septal Occluder (GCSO) with no or trivial residual shunt. No patients had vascular complications related to the procedure. Conclusions We describe a novel technique for ASD closure using the GCSO delivery sheath as the access sheath, which reduces the vascular access size requirement by 25%, thus addressing one common limitation for percutaneous device closure of a secundum ASD in young patients. © 2016 Wiley Periodicals, Inc.