Transcatheter closure of secundum atrial septal defects and fenestrated Fontan using the Amplatzer septal occluder. Initial prospective study.

OBJECTIVE

To evaluate the safety and efficacy of transcatheter closure of secundum atrial septal defects and fenestrated Fontan with the Amplatzer septal occluder.

METHODS

Fifteen consecutive patients, with a significant interatrial communications, were considered for the procedure; four patients with defects that were too large or with deficient margins were excluded after initial transesophageal echocardiography.

RESULTS

Eleven procedures were performed in 11 patients (10 atrial septal defects and 1 fenestrated Fontan) aged 9 to 38 years, mean 17.7 +/- 9 years; body weight 30 to 87 kg, mean 51.4 +/- 16. The stretched balloon diameter of the defects ranged from 8 to 28 mm, mean 18.8 +/- 6.9; the diameter of the devices ranged from 10 to 30 mm, mean 20.8 +/- 6. Immediate total occlusion rate was 18.1%, rising to 63.6% after 24 hours. Total occlusion rate at one month reached 100%. Severe transient sinus bradycardia in one (9%) was the only complications. At follow-up (10 to 26 months, mean 13.2 +/- 5.0) all patients remain asymptomatic with no residual shunt.

CONCLUSIONS

The Amplatzer septal occluder is very efficient and offered interventional interatrial communications closure in 100% of our group of consecutive patients with excellent intermediate results.