Corrected balloon occlusive diameter to determine device size during percutaneous atrial septal defect closure

OBJECTIVE
The aim of this trial was to investigate the impact of corrected balloon occlusive diameter (cBOD) on successful performance of percutaneous atrial septal defect (ASD) closure.

METHOD
The trial comprised 86 patients (60 female, 26 male; mean age 36.5±14.3) on whom percutaneous ASD closure was performed. Patients were evaluated using transesophageal echocardiography (TEE). Relation of the defect to surrounding tissues and size of rims was also investigated. Balloon sizing was performed intraoperatively on all patients. Size of device was ascertained according to both durability of rims and whether or not they formed significant indentation, both of which determine cBOD.

RESULTS
The ASD closure device was successfully implanted in 84 (97.5%) patients. Mean maximum defect size was 17.4±5.9 mm, and mean color flow diameter was 16.8±5.4 mm. Mean maximum defect size at the moment of loss of shunt flow was 18.4±5.9mm with TEE, and 18.8±6.1mm with fluoroscopy. Mean size of Amplatzer occluder device was 20.0±6.5mm. Device embolization was observed in 2 patients. However, no death occurred during or after the procedure.

CONCLUSION
Percutaneous secundum ASD closure is a safe and effective treatment modality in experienced centers. Utilizing corrected balloon occlusive diameter may be of benefit in deciding the size of ASD occluder device.