Transcatheter Closure of Large Atrial Septal Defects: Feasibility and Safety in a Large Adult and Pediatric Population

BACKGROUND—Data are needed on the safety and efficacy of device closure of large atrial septal defects. METHODS AND RESULTS—Between 1998 and 2013, 336 patients (161 children 15 mm/m in children) were managed using the Amplatzer device, at the Marie Lannelongue Hospital. Transthoracic echocardiographic guidance was used starting in 2005 (n=219; 65.2%). Balloon-stretched diameter was >40 mm in 36 adults; mean values were 37.6±3.3 mm in other adults and 26.3±6.3 mm/m in children. Amplatzer closure was successful in 311 (92.6%; 95% confidence interval, 89%–95%) patients. Superior and posterior rim deficiencies were more common in failed than in successful procedures (superior, 24.0% versus 4.8%; P=0.002; and posterior, 32.0% versus 4.2%; P