Related Experiment Video
Updated: Nov 2, 2025
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Use of cribriform amplatzer septal occluder in the pediatric population: Feasibility, safety, and technical
Priya Pradhan1, Sneha Jain1, Supratim Sen1
1Department of Pediatric Cardiology, NHSRCC Hospital, Mumbai, Maharashtra, India.
Insights
The cribriform Amplatzer Septal Occluder (ASO) is a safe and effective option for closing fenestrated atrial septal defects (F-ASDs) in children. This device allows for successful closure, even in small hearts, with minimal residual shunts.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Fenestrated atrial septal defects (F-ASDs) present challenges for transcatheter device closure in pediatric patients.
- Standard device closure techniques can be problematic due to the need for multiple devices or distortion of device profile with oversizing.
Purpose of the Study:
- To assess the feasibility and safety of using the cribriform Amplatzer Septal Occluder (ASO) for closing F-ASDs in small children.
- To evaluate the efficacy of a single cribriform ASO device in managing complex septal defects.
Main Methods:
- A retrospective observational study included sixteen children with F-ASDs undergoing device closure with cribriform ASO.
- Device size was determined based on fenestrated septal length (FSL) and total septal length (TSL), with implantation through a central fenestration.
- Transesophageal echocardiography was used for measurements.
Main Results:
- Successful device implantation was achieved in all patients.
- Complete defect closure occurred in 11 patients, with 5 showing insignificant residual shunts at a median follow-up of 40 months.
- No other complications were reported, and the cribriform ASO provided stability.
Conclusions:
- The cribriform ASO is a safe and effective device for closing F-ASDs in pediatric patients.
- Deployment through a central fenestration facilitates coverage of multiple fenestrations and enhances device stability.
- While residual shunts may occur, they are typically insignificant.
Purpose:
Fenestrated atrial septal defects (F-ASDs) in the pediatric population pose a challenge for transcatheter device closure since multiple devices are not preferred in small hearts. Oversizing the Amplatzer Septal Occluder (ASO) to cover the surrounding fenestrations usually distorts the central waist as well as the disc profile and often defeats the purpose. This is a retrospective observational study with an aim to assess the feasibility and safety of cribriform ASO in closing F-ASDs in small children.
Methods:
Sixteen children with F-ASD who underwent device closure with cribriform ASO were included in the study. The fenestrated septal length (FSL) and the total septal length (TSL) were measured on transesophageal echocardiogram. A device size which was 1.5-2 times the FSL but smaller than the TSL was selected. The defect was closed with a device passed through a relatively centrally placed smaller fenestration.
Results:
The median age of the cohort was 5 years (2.5-10.5). Majority (14/16) required 25 or 30 mm cribriform ASO. Aneurysmal interatrial septum was seen in most of our patients (11/15). All the patients had successful device implantation. Complete closure of the defect was seen in 11 patients while 5 patients had insignificant residual shunt at a median follow-up of 40 months (1-60 months). There were no other complications.
Conclusions:
Cribriform ASO can be used safely and effectively in closing F-ASDs in children. Deployment of the device through a small central hole allows covering maximum fenestrations and gives more stability to the device. Residual shunts, although not infrequent, are insignificant.
More Related Videos
08:00Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
Published on: June 15, 2015
07:41Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022