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  • Title: 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.
    Author: Wilson NJ, Smith J, Prommete B, O'Donnell C, Gentles TL, Ruygrok PN.
    Journal: Heart Lung Circ; 2008 Aug; 17(4):318-24. PubMed ID: 18407789.
    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.
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