Transcatheter Closure of Atrial Septal Defects (original) (raw)
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Transcatheter Device Closure of Atrial Septal Defects
Jacc-cardiovascular Interventions, 2013
This review discusses the current safety issues related to U.S. Food and Drug Administration approved atrial septal defect devices and proposes a potential avenue to gather additional safety data including factors, which may be involved in device erosion. Atrial septal defects (ASD) are classified into ostium primum, ostium secundum, sinus venosus, and coronary sinus types. The current reported prevalence of ASD is about 10% of congenital cardiac defects (1). ASD, although recognized as a relatively benign form of cardiac disease, if left untreated can eventually contribute to significant morbidity and mortality, as borne out by the natural history studies (2,3). Unrepaired ASD can lead to right ventricular volume overload with resultant right heart failure, elevated pulmonary vascular resistance, systemic embolism, and atrial arrhythmias. Among the various types of ASDs only the ostium secundum defect is amenable to device closure, whereas all 4 types can be surgically closed. Over the years, routine closure of ASD in childhood has been justified due to the availability of low-risk, curative surgical, and transcatheter options. Transcatheter device closure of secundum ASD is a maturing technology, now more than a decade old. This therapy has become a well-accepted alternative to surgical therapy and has been regarded as generally safe and effective. Widespread use of devices and fairly From the
Transcatheter Closure of Atrial Septal Defect
Asian Journal of Medicine and Health, 2021
Background: Over the past decade, percutaneous atrial septal defect (ASD) closure has been the preferred treatment option in many clinical programs for ASD. Percutaneous ASD closures with advanced device architecture and distribution have established user experience and process security. The ability to diagnose has also improved. The devices have evolved from the larger fixtures to the reset zone, being easily eliminated with little residual mesh material and comfortable fitting with the surrounding structures. Biodegradable technology has been introduced and will be considered as a future option. The emergence of the use of the ASD closure device over the last forty years includes improvements that reduce the incidence of adverse effects reported over the years. Issues reported in the literature include thrombus formation, air tightness, device insertion, abrasion, residual shunts and nickel hypersensitivity. Modern tools hold medium and long-term data with excellent results. Multi...
Atrial septal defect (ASD) device trans-catheter closure: limitations
Journal of Thoracic Disease, 2018
Systematic review Transcatheter closure is a widespread technique used to treat secundum atrial septal defects (ASDs). When compared to surgery, it provides a less invasive approach with quicker recovery and reduced physical and psychological impact (1-4). The first case was performed in 1976 by King and Mills (5). However, the percutaneous ASD closure fully entered the clinical arena with the introduction of Amplatzer septal occluder devices (ASO) (6). Since then, many other devices have been developed and used, such as the Gore Cardioform septal occluder (GSO), the Figulla Flexible Occlutech device, the Cardioseal/Starflex and the bio absorbable devices Biostar or Biotrek (7,8). Nowadays, almost 85-90% of all secundum ASD can be closed by using a transcatheter approach (9,10). However, several limitations may have a significant impact on the feasibility and success of percutaneous ASD closure (11,12). Limitations can be grouped as follows: (I) anatomical limitations; (II) device-related limitations; (III) associated defects and natural history associated issues; (IV) physiological limitations; (V) complications. Anatomical limitations A common underlying structure apply to all available devices: they are made of two disks and a connecting segment that keeps them together across the ASD. Two different engineering concepts have been developed, so that occluder devices can be classified as self-centering and nonself-centering ones. The Amplatzer and the Amplatzer-like devices, in which a central connecting waist fills the defect improving stability and occlusion, belong to the former, while devices such as GSO, where the connecting segment is linear, belong to the latter. All the currently available devices need to have surrounding "walls" supporting their stability. In particular, the disks of non-self-centering ones should be 1.8-2 times the diameter of the defect in order to have complete defect closure and avoid mal position or embolization (8). Main anatomical limitations to percutaneous ASD closure may be insufficient surrounding rims, multiple defects and excessively bulging atrial septal aneurisms (ASA). Typical of ostium primum ASD and sinus venosus-type defects, deficiency of surrounding rims can affect ostium
Transcatheter closure of residual atrial septal defect following implantation of buttoned device
Catheterization and Cardiovascular Diagnosis, 1995
We report a case in which residual shunting after a buttoned device occlusion of atrial septal defect (ASD) was ellmlnated by transcatheter retrieval of a portion of the device, followed by implantation of a second device. This method may be helpful for those patients with residual ASDs who decline surgical device retrleval and defect closure. c) 1995 Wlley-Us, Inc. son. AZ 85724. 2. Lloyd TR. Rao PS. Beekman RH. Mendelsohn AM. Siderib EB: Atrial septal defect occlusion with the buttoned device (a multiinstitutional U.S. trial). Am J Cardiol 73:286-291, 1994. G , Rey c, Lloyd TR, Beekman RH. Worms AM, Bourlon F, Onorato E. Khallilullah M, Haddad J: International experience with secundum atrial septal defect oc-3, ps, Sideris EB,
Transcatheter device closure of atrial septal defects in patients above age 60
Transcatheter device closure of atrial septal defects guided completely by transthoracic echocardiography: A single cardiac center experience with 152 cases This resulted in better cosmetic results than those by surgical repair. Moreover, our technique was completely guided by transthoracic echocardiography (TTE), thus avoiding X-ray exposure. This study aimed to evaluate the safety and efficacy of our procedure, and the results were found to be encouraging. Methods This study was approved by the Ethics Committee of Fujian Medical University, China, and adhered to the tenets of the Declaration of Helsinki. In addition, written informed consent was obtained from the patients or parents of the patients. All patients who enrolled at our cardiac center between September 2014 and June 2017 were included in the study. They were divided into two groups based on the therapeutic method chosen. Group I included 152 patients (62 males and 90 females) undergoing transcatheter device closure guided completely by Objective: This study aimed to assess the safety and feasibility of transcatheter device closure of atrial septal defects (ASDs) guided completely by transthoracic echocardiography (TTE). Methods: A total of 152 patients underwent transcatheter device closure of ASDs guided completely by TTE in our center from September 2014 to June 2017. We used routine delivery sheaths during the procedure and then closed the ASDs by releasing a domestic occluder. Results: The closure was successful in 150 patients, and surgical repair was required in two patients. The size of the deployed occluder ranged from 10 mm to 38 mm (21.4±8.5 mm), and the procedure duration ranged from 30 to 90 min (38.2±21.4 min). No fatal complications were observed. Minor complications included transient arrhythmias (n=12) during the process of device deployment. The follow-up period was 3 months to 2 years, with no occluder dislodgment, residual fistula, or thrombus-related complications. In our comparative studies, no statistically significant differences were observed in success rates and complications. Conclusion: Transcatheter device closure of ASDs guided completely by TTE may be safe and effective and can be an alternative to traditional methods.
American Heart Journal, 2004
Background: The transcatheter closure of the atrial septal defect (ASD) has become an alternative technique to surgical procedures. The aim of this study was to assess the immediate, short, and intermediate-term results of the transcatheter closure of the secundum ASD with the Amplatzer Septal Occluder (ASO) in adult Iranian patients. Methods: Between December 2004 and July 2008, the transcatheter closure of the ASD using the ASO was attempted in 58 consecutive, adult patients. The mean age of the patients was 37.1 ± 12.7 years (range = 19 -75 years).