Closure of secundum atrial septal defects by the Amplatzer occluder device

OBJECTIVES
Percutaneous closure of secundum atrial septal defects (ASD) has become an important alternative treatment to surgery. We evaluated our clinical experience with, and short-term results of transcatheter closure of ASDs with the Amplatzer septal occluder in adult patients.

STUDY DESIGN
The study included 52 patients (36 women, 16 men; mean age 33±14 years; range 14 to 69 years) who underwent transcatheter ASD closure with the Amplatzer occluder device. The mean ASD diameter measured by transesophageal echocardiography was 19.5±5.7 mm and the mean device diameter was 24.5±5.7 mm. All the patients were assessed clinically and echocardiographically one month after the procedure.

RESULTS
Transcatheter ASD closure was successfully performed in 48 patients (92.3%) and failed in four patients (7.7%). Echocardiographic controls showed significant decreases in tricuspid regurgitation, right ventricular dilatation, and pulmonary artery pressure (p=0.003, p=0.026, and p=0.0001, respectively). Functional capacity of the patients also showed significant improvements (p=0.0001). After implantation, residual shunts were detected in four patients, all of which disappeared one month after the procedure. Major complications were seen in two patients. One patient developed ventricular fibrillation immediately after the procedure due to device embolization. One patient with left ventricular dysfunction developed device thrombosis due to cessation of dual antiplatelet therapy, which was successfully treated by anticoagulation therapy. Arrhythmia was not observed in any patient.

CONCLUSION
Percutaneous closure of secundum ASDs with the Amplatzer occluder device is a safe and effective procedure with a high success rate.