Skip to main content Accessibility help
×
Home

Transcatheter closure of atrial septal defects within the oval fossa: medium-term results in children using the ‘ASDOS’-technique

  • Gerd Hausdorf (a1), Martin Schneider (a2), Christoph Fink (a2), Ulrich Neudorf (a3), Gunther Fischer (a4), Michael Tynan (a5) and Beat Friedli (a6)...

Abstract

Objectives

The purpose of this study was to evaluate the safety and efficacy of the ASDOS-tech-nique (Sulzer-Osypka GmbH, Germany) for transcatheter closure of atrial septal defects within the oval fossa.

Background

Although several attempts have been made to occlude defects within the oval fossa by transcatheter techniques, none of these has gained general acceptance.

Methods

Patients with a defect in the oval fossa measuring equal to or less than 20 mm diameter, with a residual septal rim of 5mm or greater, body weight greater than 10 kg, with clinical indications for surgical closure were considered for transcatheter closure. Follow-up investigations were performed at discharge, after 1, 3, 6 and 9 months, as well as after 1 and 2 years.

Results

Of 78 patients considered for closure, a device was inserted in 41 patients (53%), with success being achieved in 40 patients (98%). The ages ranged from 1.1 to 15 years (7.8 ± 1.92 years), the ’stretched’ diameter of the defect from 10 to 20 mm (14.7 ± 2.60 mm), and the diameters of the inserted devices from 25 to 45 mm (33.2 ± 5.43 mm). Transient impairment of atrioventricular conduction occured in 4 patients. During the follow-up of 23.0 ± 5.6 months elective surgical closure of a residual shunt was performed 26 months after insertion of the devcie in one patient. None of the other patients required surgery, hospitalisation or medical treatment, and none is requiring further treatment of the defect within the oval fossa. Fracture of one arm of the device occurred in 4 patients, but the fractured arms are in an unchanged and stable position after a period of at least 19 months.

Conclusions

Our medium-term data show that transcatheter closure in children of defects within the oval fossa can be performed with a high efficacy and safety using the ASDOS-device.

Copyright

Corresponding author

Prof.Dr.Gerd Hausdorf, Medizinische Hochschule Hannover, Department of Pediatrics III and Pediatric Cardiology, Carl-Neuberg Str.l, D-30625 Hannover, Germany. Fax: 511-532-9038

References

Hide All
1.Pastorek, JS, Allen, HD, Davis, JT. Current outcomes of surgical closure of secundum atrial septal defect. Am J Cardiol. 1994, 74: 7577.
2.Galal, MO, Wobst, A, Halees, Z, Hatle, L, Schmaltz, AA, Khougeer, F, De Vol, E, Fawzy, ME, Abbag, F, Fadley, F, Duran, CMG. Peri operative complications following surgical closure of atrial septal defect type II in 232 patients-a baseline study. Eur Heart J. 1994, 15: 13811384.
3.Massetti, M, Babatasi, G, Rossi, A, Neri, E, Bhoyroo, S, Zitouni, S, Maragnes, P, Khayat, AOperation for atrial septal defect through a right anterolateral thoracotomy: current outcome. Ann Thorac Surg. 1996,62: 11001103.
4.Chang, CH, Lin, PJ, Chu, JJ, Liu, HP, Tsai, FC, Lin, FC, Chiang, CW, Su, WJ, Yang, MW, Tan, PPVideo assisted cardiac surgery in closure of atrial septal defect. Ann Thorac Surg. 1996, 62: 697701.
5.King, TD, Thompson, SL, Steiner, C, Mills, NL. Secundum atrial septal defect: nonoperative closure during cardiac catheteriza-tion. JAMA 1976, 235: 25062509.
6.Rashkind, WJ. Transcatheter treatment of congenital heart dis ease. Circulation 1983, 67: 711717.
7.Rao, PS, Sideris, EB, Hausdorf, G, Rey, Ch, Lloyd, TR, Beekman, RH, Worms, AM, Bourlon, F, Onorato, E, Khalilullah, M, Haddad, J. International experience with secundum atrial sep tal defect occlusion by the buttoned device. Am Heart J 1994, 128: 10221035.
8.Sideris, EB, Sideris, SE, Fowlkes, JP, Ehly, RL, Smith, JE, Guide, RE. Transvenous atrial septal defect occlusion in piglets with a ‘buttoned’ double-disk device. Circulation 1990, 81: 312318.
9.Rome, JJ, Keane, JF, Perry, SB, Spevak, PJ, Lock, JE. Double-umbrella closure of atrial defects. Initial clinical applications. Circulation 1990, 82: 751758.
10.Lock, JE, Rome, JJ, Davis, R, Van Praagh, S, Perry, SB, Van Praagh, R, Keane, JF. Transcatheter closure of atrial septal defects, Experimental studies. Circulation 1989, 79: 10911099.
11.Das, GS, Voss, G, Jarvis, G, Wyche, K, Gunther, R, Wilson, RF. Experimental atrial septal defect closure with a new, tran-scacheter, self-centering device. Circulation 1993, 88: 17541764.
12.Babic, UU, Grujicic, S, Popovic, Z, Djurisic, Z, Vacinic, M, Pejcic, PDouble-umbrella device for transvenous closure of patent ductus arteriosus and atrial septal defect. First experience. J Interven Cardiol 1991, 4: 283294.
13.Sharafuddin, MJA, Gu, X, Titus, JL, Urness, M, Cervera-Ceballos, JJ, Amplatz, K. Transvenous closure of secundum atrial septal defects. Preliminary results with a new self-expanding nitinol prothesis in a swine model. Circulation 1997, 95: 21722178.
14.Hausdorf, G, Schneider, M, Franzbach, B, Kampmann, C, Kargus, K, Goeldner, B. Transcatheter closure of secundum atrial septal defects with the atrial septal defect occlusion sys tem (ASDOS): initial experience in children. Heart 1996, 75: 8388.
15.Masura, J, Gavora, PFormanek, A, Hijazi, ZMTranscatheter clo sure of secundum atrial septal defects using the new self-cen tering amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn. 1997, 42: 388393.
16.King, TD, Thompson, SL, Mills, NL. Measurement of atrial sep tal defect during cardiac catheterization: experimental and clinical trials. Am J Cardiol 1978, 41: 537542.
17.Hellenbrand, WE, Fahey, JT, McGowan, FX, Weltin, GG, Kleinman, CS. Transesophageal echocardiographic guidance of transcatheter closure of atrial septal defect. Am J Cardiol. 1990,66: 207213.
18.Rao, PS, Langhough, R, Beekman, RH, Lloyd, TR, Sideris, EB. Echocardiographic estimation of balloon-stretched diameter of secundum atrial septal defect for transcatheter occlusion. Am Heart J. 1992, 124: 172175.
19.Worms, AM, Rey, C, Bourlon, F, Losay, J, Marcon, F, Godart, F, Coullet, JM. French experience in the closure of atrial septal defects of the ostium secundum type with the Sideris button occluder. Arch Mai Coeur Vaiss. 1996, 89: 509515.
20.Agarwal, SK, Ghosh, PK, Mitral, PK. Failure of devices used for closure of atrial septal defects: mechanisms and management. J Thorac Cardiovasc Surg 1996, 112: 2126.
21.Bohm, J, Bittigau, K, Kohler, F, Baumann, G, Konertz, WSurgical removal of atrial septal defect occlusion system-devices.Eur J CardiothoracSurg 1997, 12: 869872.
22.Sievert, H, Babic, UU, Ensslen, R, Scherer, D, Spies, H, Wiederspahn, T, Zeplin, HE. Transcatheter closure of large atrial septal defects with the Babic system. Cathet Cardiovasc Diagn 1995, 36: 232240.
23.Rao, PS, Ende, DJ, Wilson, AD, Smith, PA, Chopra, PS. Follow-up results of transcatheter occlusion of atrial septal defects with buttoned device. Can J Cardiol. 1995, 11: 695701.
24.Arora, R, Trehan, VK, Kalra, GS, Chawla, R, Jhamb, U, Nigam, M, Kenchaiah, KS, Bhardwaj, S, Khalilullah, M. Transcatheter closure of atrial septal defect using buttoned device-Indian experience. Indian Heart J 1996, 48: 145149.
25.Rosenfeld, HM, van der Velde, ME, Sanders, SPColan, SD, Parness, IA, Lock, JE, Spevak, PJ. Echocardiographic predictors of candidacy for successful transcatheter atrial septal defect clo sure. Cathet Cardiovasc Diagn 1995, 34: 2934.
26.Reddy, SC, Rao, PS, Ewenko, J, Koscik, R, Wilson, AD. Echocardiographic predictors of success of catheter closure of atrial septal defect with the buttoned device. Am Heart J 1995, 129: 7682.
27.Koike, K, Echigo, S, Kumate, M, Kobayashi, T, Isoda, T, Ishii, M, Ishizawa, A, Kamiya, T, Kato, H. Transcatheter closure of atrial septal defect with a prototype clamshell septal umbrella: one year follow-up. J Cardiol 1994, 24: 5360.
28.Justo, RN, Nykanen, DG, Boutin, C, McCrindle, BW, Freedom, RM, Benson, LN. Clinical impact of transcatheter closure of secundum atrial septal defects with the double umbrella device. Am J Cardiol 1996, 77: 889892.
29.Prieto, LR, Foreman, CK, Cheatham, JP, Latson, LA. Intermediate-term outcome of transcatheter secundum atrial septal defect closure using the Bard Clamshell Septal Umbrella. Am J Cardiol 1996, 78: 13101312.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed