Transcatheter closure of secundum atrial septal defects and fenestrated Fontan using the Amplatzer septal occluder. Initial prospective study
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Published on: December 23, 2022
Carlos Alva1, Felipe David, José Ortegón
1Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Av. Cuauhtémoc 330, Col. Doctores, México, D.F. CP 06720. echoca@yahoo.com.mx
Objective:
To evaluate the safety and efficacy of transcatheter closure of secundum atrial septal defects and fenestrated Fontan with the Amplatzer septal occluder.
Methods:
Fifteen consecutive patients, with a significant interatrial communications, were considered for the procedure; four patients with defects that were too large or with deficient margins were excluded after initial transesophageal echocardiography.
Results:
Eleven procedures were performed in 11 patients (10 atrial septal defects and 1 fenestrated Fontan) aged 9 to 38 years, mean 17.7 +/- 9 years; body weight 30 to 87 kg, mean 51.4 +/- 16. The stretched balloon diameter of the defects ranged from 8 to 28 mm, mean 18.8 +/- 6.9; the diameter of the devices ranged from 10 to 30 mm, mean 20.8 +/- 6. Immediate total occlusion rate was 18.1%, rising to 63.6% after 24 hours. Total occlusion rate at one month reached 100%. Severe transient sinus bradycardia in one (9%) was the only complications. At follow-up (10 to 26 months, mean 13.2 +/- 5.0) all patients remain asymptomatic with no residual shunt.
Conclusions:
The Amplatzer septal occluder is very efficient and offered interventional interatrial communications closure in 100% of our group of consecutive patients with excellent intermediate results.
