Historical Aspects of Transcatheter Occlusion of Atrial Septal Defects

Following the description of surgical closure of atrial septal defect (ASD) in early 1950s (Bigelow et al., 1950; Lewis et al., 1953; Gibbon, 1953), it rapidly became a standard therapy of ASDs. Surgical closure of ostium secundum ASDs is safe and effective with negligible mortality (Murphy et al., 1990; Galal et al., 1994; Pastorek et al., 1994), but the morbidity associated with sternotomy/thoracotomy, cardiopulmonary bypass and potential for postoperative complications cannot be avoided. Other disadvantages of surgical therapy are the expense associated with surgical correction, residual surgical scar and psychological trauma to the patients and/or the parents. Presumably because of these reasons, several groups of cardiologists embarked upon developing transcatheter methods of closure of the ASD. The studies of King (King & Mills, 1974; Mills & King, 1976; King et al., 1976), Rashkind (Rashkind, 1975; Rashkind & Cuaso, 1977; Rashkind, 1983) and their associates paved the way for the future development of transcatheter ASD device occlusion methodology. In this chapter, history of development of ASD closure devices will be reviewed. Historical development for occlusion of patent foramen ovale (PFO) will be briefed at the end of the chapter.