Congenital Heart Disease Transcatheter Closure of Atrial Septal Defects with the Amplatzer Septal Occluder Clinical Results

Objective: To assess the short-term outcome following transcatheter closure of secundum atrial septal defect (ASD) in our hospital. Patients and Methods: Between June 2000 and November 2001, 20 patients diagnosed as secundum atrial septal defects underwent transcatheter closure of their defects using the Amplatzer septal occluder (ASO) device. Indications for 18 patients were larger atrial septal defects with Qp:Qs > 1.5 and transthoracic echocardiography study revealing right heart dilatation and paradoxical interventricular septal motion. All patients were followed up for a period of 6 months to 2 years. Results: Nineteen ASO devices were successfully implanted in 20 patients. One patient was referred for surgery due to implantation failure. The success rate was 95%. The median age of the patients was 10.1 years. Male to female ratio was 1: 1.5. The mean Qp:Qs ratio was 2.5:1. The ASD size was measured as 7-26.5 mm (mean S.D; 16.5 5.9 mm) on transoesophageal echocardiogram, and its diameter 8-29.5 mm (19.4 6.5 mm) using the balloon-stretched method. The implanted device size ranged from 9-34 mm. Fluoroscopy time for the procedure ranged from 9.7-41.2 minutes (23.2 9.0 minutes). Follow-up periods ranged from 6 months to 2 years. No late complications have been found at follow-up visits. Conclusions: Transcatheter closure of secumdum ASDs with the Amplatzer septal occluder is a safe and effective alternative to surgery. With careful selection of patient group, secumdum ASDs can be successfully closed with minimal procedural morbidity and excellent result. Long-term follow up is necessary to compare the result with surgical closure.