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Related Experiment Videos

Interventional pediatric cardiology: device closures.

J L Wilkinson1

  • 1Royal Children's Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia.

Indian Journal of Pediatrics
|December 29, 2000
PubMed
Summary

Transcatheter closure of septal defects, including patent ductus arteriosus (PDA) and atrial septal defects (ASD), offers high closure rates. However, device cost and long-term outcomes require further evaluation.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Surgical repair of septal defects is well-established.
  • Transcatheter techniques for valvular stenosis and vascular obstruction are routine.
  • Catheter-based closure of septal defects is a developing field.

Purpose of the Study:

  • To review the evolution and current status of transcatheter device closure for septal defects.
  • To discuss various devices used for patent ductus arteriosus (PDA) and atrial septal defects (ASD).
  • To highlight challenges and controversies in device closure for ventricular septal defects (VSD).

Main Methods:

  • Review of historical and contemporary devices for PDA closure (e.g., Ivalon plug, coils, Amplatzer PDA occluder).
  • Review of devices for secundum ASD closure (e.g., clamshell, Amplatzer, CardioSEAL).
  • Discussion of the challenges associated with VSD device closure.

Main Results:

  • High closure rates (95-98%) reported for PDA and ASD device closure.
  • Some devices are expensive compared to surgical ligation for PDA.
  • Amplatzer devices are widely used for ASD closure, but no single device is ideal.
  • Long-term outcomes like endothelialization, arrhythmias, and endocarditis require further study.
  • VSD device closure remains challenging and is limited to specific cases.

Conclusions:

  • Transcatheter device closure is increasingly used for select ASD cases.
  • Device closure for PDA and ASD shows high efficacy but cost and long-term data are considerations.
  • VSD device closure is complex and not yet widely applicable.

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