Transcatheter closure of very large (≥ 25 mm) atrial septal defects using the Amplatzer septal occluder
Between June 1999 and September 2002, 45 patients (age, 34 ± 13 years; mean shunt ratio, 2.6 ± 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.4 ± 3 mm). Patients were selected by transesophageal echocardiogr...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2003-08, Vol.59 (4), p.522-527 |
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| creator | Kannan, Bhava Ramalingam Jawahar Francis, Edwin Sivakumar, Kothandam Anil, Sivadasan Radha Kumar, Raman Krishna |
| description | Between June 1999 and September 2002, 45 patients (age, 34 ± 13 years; mean shunt ratio, 2.6 ± 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.4 ± 3 mm). Patients were selected by transesophageal echocardiography. The mean ASD dimension was 25.3 ± 3.7 mm and 33 (73%) patients had deficient anterior rim. Specific procedural details included the use of 13 or 14 Fr introducer sheaths and the right upper pulmonary vein approach if the conventional approach failed. There were two procedural failures, with device embolization in both (surgical retrieval in one, catheter retrieval in one). During follow‐up (3–30 months; median, 16 months), one patient (59 years) with previous atrial flutter had pulmonary embolism and was managed with anticoagulation. Two patients developed symptomatic atrial flutter. Fluoroscopy time was 31.6 ± 19.5 min for the first 22 cases and 19.6 ± 11.4 min for the rest (P = 0.04). Transcatheter closure of large ASDs is technically feasible but careful long‐term follow‐up is needed to document its safety. Cathet Cardiovasc Intervent 2003;59:522–527. © 2003 Wiley‐Liss, Inc. |
| doi_str_mv | 10.1002/ccd.10575 |
| format | Article |
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Patients were selected by transesophageal echocardiography. The mean ASD dimension was 25.3 ± 3.7 mm and 33 (73%) patients had deficient anterior rim. Specific procedural details included the use of 13 or 14 Fr introducer sheaths and the right upper pulmonary vein approach if the conventional approach failed. There were two procedural failures, with device embolization in both (surgical retrieval in one, catheter retrieval in one). During follow‐up (3–30 months; median, 16 months), one patient (59 years) with previous atrial flutter had pulmonary embolism and was managed with anticoagulation. Two patients developed symptomatic atrial flutter. Fluoroscopy time was 31.6 ± 19.5 min for the first 22 cases and 19.6 ± 11.4 min for the rest (P = 0.04). Transcatheter closure of large ASDs is technically feasible but careful long‐term follow‐up is needed to document its safety. 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Cardiovasc. Intervent</addtitle><description>Between June 1999 and September 2002, 45 patients (age, 34 ± 13 years; mean shunt ratio, 2.6 ± 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.4 ± 3 mm). Patients were selected by transesophageal echocardiography. The mean ASD dimension was 25.3 ± 3.7 mm and 33 (73%) patients had deficient anterior rim. Specific procedural details included the use of 13 or 14 Fr introducer sheaths and the right upper pulmonary vein approach if the conventional approach failed. There were two procedural failures, with device embolization in both (surgical retrieval in one, catheter retrieval in one). During follow‐up (3–30 months; median, 16 months), one patient (59 years) with previous atrial flutter had pulmonary embolism and was managed with anticoagulation. Two patients developed symptomatic atrial flutter. Fluoroscopy time was 31.6 ± 19.5 min for the first 22 cases and 19.6 ± 11.4 min for the rest (P = 0.04). Transcatheter closure of large ASDs is technically feasible but careful long‐term follow‐up is needed to document its safety. Cathet Cardiovasc Intervent 2003;59:522–527. © 2003 Wiley‐Liss, Inc.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization - methods</subject><subject>catheter interventions</subject><subject>congenital heart disease</subject><subject>Diseases of the cardiovascular system</subject><subject>Echocardiography, Transesophageal</subject><subject>Embolization, Therapeutic - instrumentation</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Follow-Up Studies</subject><subject>Heart Septal Defects, Atrial - diagnostic imaging</subject><subject>Heart Septal Defects, Atrial - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Prosthesis Implantation - methods</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. 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Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kannan, Bhava Ramalingam Jawahar</creatorcontrib><creatorcontrib>Francis, Edwin</creatorcontrib><creatorcontrib>Sivakumar, Kothandam</creatorcontrib><creatorcontrib>Anil, Sivadasan Radha</creatorcontrib><creatorcontrib>Kumar, Raman Krishna</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kannan, Bhava Ramalingam Jawahar</au><au>Francis, Edwin</au><au>Sivakumar, Kothandam</au><au>Anil, Sivadasan Radha</au><au>Kumar, Raman Krishna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter closure of very large (≥ 25 mm) atrial septal defects using the Amplatzer septal occluder</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Cathet. 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| subjects | Adolescent Adult Biological and medical sciences Cardiac Catheterization - methods catheter interventions congenital heart disease Diseases of the cardiovascular system Echocardiography, Transesophageal Embolization, Therapeutic - instrumentation Female Fluoroscopy Follow-Up Studies Heart Septal Defects, Atrial - diagnostic imaging Heart Septal Defects, Atrial - therapy Humans Male Medical sciences Middle Aged Patient Selection Prosthesis Implantation - methods Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Time Factors Treatment Outcome |
| title | Transcatheter closure of very large (≥ 25 mm) atrial septal defects using the Amplatzer septal occluder |
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