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Morphological variations of secundum-type atrial septal defects: feasibility for percutaneous closure using Amplatzer
T Podnar1, P Martanovic, P Gavora
1The Children's Cardiac Center, University Children's Hospital, Bratislava, Slovakia. tomaz.podnar@mf.uni-lj.sl
Insights
This study assessed atrial septal defect (ASD) morphology for percutaneous closure. Many ASD variations are suitable for Amplatzer septal occluder (ASO) closure, making it a viable option.
Area of Science:
- Cardiology
- Interventional Cardiology
- Echocardiography
Background:
- Atrial septal defects (ASDs) are common congenital heart conditions.
- Secundum-type ASDs represent the most frequent subtype.
- Percutaneous closure offers a minimally invasive alternative to surgery.
Purpose of the Study:
- To evaluate the morphological characteristics of secundum-type ASDs.
- To determine the suitability of these defects for percutaneous closure with Amplatzer septal occluders (ASO).
Main Methods:
- Retrospective analysis of 190 patients with isolated secundum-type ASD.
- Transthoracic and transesophageal echocardiography used for morphological assessment.
- Comparison of percutaneous closure with ASO versus surgical closure outcomes.
Main Results:
- Morphological variations were observed in 75.8% of patients.
- Percutaneous closure with ASO was performed in 79.5% of cases.
- Suitable morphologies for ASO closure included central defects, deficient rims, multiple defects, and septal aneurysms.
Conclusions:
- Secundum-type ASD morphology exhibits significant variation.
- Percutaneous closure with ASO is feasible and effective for a majority of these defects.
- Specific morphological features predict successful ASO closure.
Abstract:
The aim of the study was to assess the morphology of secundum-type atrial septal defects (ASD) with a view to percutaneous closure using Amplatzer septal occluders (ASO). One hundred and ninety patients who underwent closure of isolated secundum-type ASD between September 1995 and January 2000 were included. The morphology of the defects was studied using transthoracic and transesophageal echocardiography. Patients with defects of suitable morphology and size underwent percutaneous closure using ASO. The remaining patients underwent surgical closure. Centrally placed defects were observed in 46 patients (24.2%). Morphological variations of secundum-type ASD were detected in 144 patients (75.8%). One hundred and fifty-one patients (79.5%) underwent percutaneous closure using ASO. Thirty-nine patients (20.5%) underwent surgical closure. Centrally placed defects, defects with deficient superior anterior rim, multiple defects, and perforated aneurysms of the interatrial septum are morphological variations of secundum-type ASD suitable for percutaneous closure using ASO. Cathet Cardiovasc Intervent 2001;53:386-391.