Effectiveness of the Amplatzer device for transcatheter closure of an ostium secundum atrial septal defect.

OBJECTIVE

To evaluate the effectiveness of the Amplatzer septal occluder in the treatment of ostium secundum atrial septal defects (OS ASDs).

METHODS

Retrospective cohort study conducted between November 1998 and September 2005 involving 101 OS ASD transcatheter occlusion procedures in our institution. All procedures were conducted in the hemodynamic laboratory under general anesthesia with transoesophageal echocardiographic monitoring (TEE). Clinical and echocardiography assessments of the patients were conducted at 30 days, six months and on an annual basis. The results are presented as averages, standard deviations and percentages. Event-free survival was estimated using the Kaplan-Meier curve.

RESULTS

From the 101 patients, 60 (59.4%) were females. Mean age, weight, height, body mass index and body surface area were, respectively: 24.3 +/- 18.31 years, 51.88 +/- 23.76 kg, 140.59 +/- 39.3 cm, 23.18 +/- 18.9 kg/m(2) and 1.24 +/- 0.21 m(2). The prevalence of interatrial septum aneurysms was 4.95%, and 98 cases had an isolated defect. ASD diameters were 21.47 +/- 6.96 mm using an angiography and 21.22 +/- 7.93 mm using a TEE. The average size of the implanted devices was 23.92 +/- 7.25 mm, ranging from 9 mm to 40 mm. The procedure time was 90.47 +/- 26.67 minutes and the average hospital stay was 2.51 +/- 0.62 days. Clinical and echocardiography follow-up was conducted at 12.81 +/- 8.41 months and all devices were securely anchored without any residual shunts. The procedure success rate was 93% (94/101). In five cases adequate deployment of the device was not possible and 2 patients presented residual ASD. No major complications occurred.

CONCLUSION

The Amplatzer septal occluder is an effective OS ASD transcatheter treatment device.