Transcatheter closure of secundum atrial septal defects with the Amplatzer septal occluder in adults and children-follow-up closure rates, degree of mitral regurgitation and evolution of arrhythmias

Heart Lung Circ. 2008 Aug;17(4):318-24. doi: 10.1016/j.hlc.2007.10.013. Epub 2008 Apr 14.

Abstract

Aim: To report the results of transcatheter atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO) from the single centre providing interventions for congenital heart disease in New Zealand.

Methods: A single centre retrospective review of all patients 1997-2004 inclusive, undergoing planned transcatheter ASD closure was undertaken. Implantation success, complications and latest patient follow-up are described.

Results: Percutaneous ASD closure was planned in 227 adults and children. (55% had additional medical co-morbidities.) The mean ASD size was 22+/-6 mm, and device size ranged from 5 to 40 mm. Closure was successful in 93%, unsuccessful in 5% and not attempted in 2%. There were two device embolisations, one immediately post-release and one within 24h. Minor procedural complications occurred in 5% of patients. There were no cases of suspected or proven device erosion. Ninety-two percent had documented follow-up beyond 6 months. At latest follow-up the closure rate was 98.5%. There was no significant change in the degree of mitral regurgitation. Sixteen of 24 with pre-closure arrhythmias resolved while 10 remained in atrial fibrillation. Six patients developed new arrhythmias but these were well controlled medically.

Conclusion: There is a high implantation and closure rate using transcatheter ASD closure with the Amplatzer septal occluder in children and adults avoiding the need for cardiac surgery. Follow-up at one year shows there is no progression of mitral regurgitation, and supraventricular arrhythmias have usually resolved.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arrhythmias, Cardiac / complications
  • Cardiac Catheterization
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Heart Failure / etiology
  • Heart Failure / surgery*
  • Heart Septal Defects, Atrial / complications
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / complications
  • Prostheses and Implants*
  • Prosthesis Implantation / instrumentation*
  • Prosthesis Implantation / methods
  • Retrospective Studies