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Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder

Published online by Cambridge University Press:  19 August 2008

Felix Berger
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Peter Ewert
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Per G. Boöjrnstad
Affiliation:
Rikshospitalet, Oslo, Norway
Ingo Dähnert
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Gregor Krings
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Ira Brilla-Austenat
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Michael Vogel
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Peter E. Lange
Affiliation:
Klinik für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
Corresponding
E-mail address:

Abstract

To judge whether an Amplatzer™ Septal Occluder can be used as standard therapy instead of surgery for closure of atrial septal defects we report our experiences in 200 patients. Of these patients, 127 had an atrial septal defect with haemodynamically significant left-to-right shunt, 68 patients a persistent oval foramen after presumed paradoxical embolism, and 5 had a fenestration after Fontan-repair. Mean age was 29.8 years (0.8 to 77.7 years). Body weight ranged from 6.9 to 120.0 kg (mean 51.5 kg). After diagnostic cardiac catheterization, and balloon-sizing of the defect, we implanted Amplatzer™ Septal Occluders with stents of 4 to 28 mm diameter. Follow-up studies were obtained after 48hours, and one, six, and twelve months. Transcatheter closure of the atrial septal defect proved successful in all without any relevant residual shunts. In particular, complete closure was achieved in all patients after presumed paradoxical embolism. The mean period of follow-up is 9–5 months, with a range from 0.4 to 23.5 months, giving a total of 1898 patient months. The occlusion rate after three month was 98.1°. A trivial haemodynamically insignificant residual shunt remained in 1.9° of the patients. Fluoroscopy times ranged from 0 to 43.5 minutes, with a median of 8.7 minutes. The excellent results in the short and medium term in children and adults have resulted in using this device routinely at the present time for closure of central atrial septal defects up to a diameter of 28 mm. Final judgement, however, is only possible after long-term follow-up.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

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Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder
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