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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Device closure of atrial septal defect: medium-term outcome with special reference to complications

Masood Sadiq1, Tehmina Kazmi, Asif U Rehman

  • 1Department of Paediatric Cardiology, The Children's Hospital, Ferozepur Road, Lahore, Pakistan. drmasoodsadiq@hotmail.com

Cardiology in the Young
|July 12, 2011
PubMed

Insights

Device closure for secundum atrial septal defects is safe and effective long-term. Key complications like embolisation and residual shunts are linked to specific anatomical factors, while aortic regurgitation risk remains low.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Concerns exist regarding device closure of secundum atrial septal defects (ASD), particularly regarding erosions and aortic regurgitation.
  • Transcatheter device closure has become a common alternative to surgical repair for ASD.

Purpose of the Study:

  • To evaluate the medium-term outcomes of transcatheter device closure for secundum ASD.
  • To specifically assess the incidence of complications such as erosions and aortic regurgitation.

Main Methods:

  • 205 patients with secundum ASD underwent transcatheter closure using the Amplatzer Septal Occluder between 1999 and 2009.
  • Medium-term follow-up data was available for 176 patients (88%).

Main Results:

  • Successful device closure was achieved in 98% of patients.
  • Complications included device embolisation (associated with short inferior caval vein margin), residual shunts (associated with short superior caval vein margin), and mild aortic regurgitation (linked to a high device-to-defect ratio).
  • No erosions, late embolisation, or thromboembolism were observed.

Conclusions:

  • Transcatheter device closure of secundum ASD with the Amplatzer device is safe and effective in the medium term.
  • Specific anatomical features predict risks of embolisation and residual shunts.
  • The risk of aortic regurgitation is low and predictable based on device selection.
Abstract

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