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Updated: Aug 15, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Percutaneous closure with Amplatzer device is a safe and efficient alternative to surgery in adults with large atrial
1Hôpital Marie Lannelongue, Université Paris-Sud., Le Plessis Robinson, France. jlosay@ccml.com
Insights
Transcatheter closure using the Amplatzer occluder is an effective treatment for adults with large atrial septal defects (ASDs) and significant shunts, offering a less invasive alternative to surgery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Adult Congenital Heart Disease
Background:
- Atrial septal defect (ASD) closure is recommended for adults with large right-to-left shunts.
- Percutaneous closure is underutilized in this patient group.
- This study evaluates transcatheter closure in adults with large ASDs.
Purpose of the Study:
- To assess the efficacy and safety of transcatheter closure for large atrial septal defects (ASDs) in adults.
- To compare percutaneous closure outcomes with surgical intervention.
Main Methods:
- 44 adult patients with secundum ASD and specific criteria (QP/QS ≥2, RV overload, or ASD size >20 mm) were studied.
- Transcatheter closure was performed using the Amplatzer occluder.
- Follow-up included oximetry and echocardiography.
Main Results:
- Successful implantation was achieved in 42 out of 44 patients.
- At 6-month follow-up, 95% of patients showed complete closure; 2 had small residual shunts.
- Major complications included device embolization and cerebrovascular accident; minor complications were transient.
Conclusions:
- Transcatheter closure of large ASDs with the Amplatzer device is an efficient procedure.
- This method demonstrates lower morbidity compared to surgical closure for atrial septal defects.
Background:
In adults with atrial septal defect (ASD) and large right-to-left shunt, closure of the defect is recommended. Percutaneous closure is still rarely used in this population. This study presents the results of transcatheter closure with the Amplatzer occluder in such patients.
Methods And Results:
We studied 44 consecutive adult patients with a secundum ASD and 2 of the 3 following criteria: QP/QS >/=2 by oximetry, echocardiographic right ventricle overload, and ASD size >20 mm. Forty-two patients had a successful implantation. In 1 patient an unstable device was withdrawn; in another one, the device embolized in the pulmonary artery. At 6-month median follow-up, 95% had a complete closure; 2 patients with an additional defect had a small residual shunt. Major complications were the aforementioned embolization and a cerebrovascular accident in a patient with atrial fibrillation treated with aspirin. Others were minor and transitory: premature atrial beats in 3 patients, and paroxysmal atrial fibrillation and pulmonary edema in 1 patient each.
Conclusions:
Transcatheter closure of large ASDs with the Amplatzer device is efficient with less morbidity than surgical closure.
