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[Catheter closure in atrial septal defects and open foramen ovale using the Sideris buttoned device]
B Hellmüller1, U Kaufmann, B Aeschbacher
1Departement Innere Medizin, Universitätsklinik, Inselspital Bern.
Insights
Transcatheter closure effectively treats atrial septal defects (ASDs) and patent foramen ovale (PFOs). This minimally invasive technique offers a safe alternative to surgery, with a low rate of recurrent embolic events.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Percutaneous closure is an alternative to surgical repair for significant atrial septal defects (ASDs) and patent foramen ovale (PFOs).
- PFOs can be associated with cryptogenic stroke and systemic embolism.
- Transcatheter closure offers a less invasive approach compared to surgical intervention.
Purpose of the Study:
- To report the initial outcomes of transcatheter closure for ASDs and PFOs using the Sideris buttoned device.
- To evaluate the efficacy and safety of this device in a cohort of patients.
Main Methods:
- Transcatheter closure was attempted in 35 patients (19 with ASDs, 16 with PFOs).
- The Sideris buttoned device was used in all cases.
- Diagnosis and follow-up primarily utilized transesophageal echocardiography.
Main Results:
- Successful closure was achieved in the treated patients.
- For ASDs, the mean defect size reduced from 24 mm to 4 mm post-treatment.
- In patients with PFOs, including 14 with prior embolic events, only one experienced a recurrent event during 104 patient-months follow-up.
Conclusions:
- Transcatheter closure with the Sideris buttoned device is a viable option for ASD and PFO closure.
- The procedure demonstrates favorable short-term efficacy and safety, with a low risk of recurrent embolism.
- Further studies are warranted to confirm long-term outcomes.
Abstract:
Percutaneous nonsurgical closure is an alternative to surgical repair of a significant atrial septal defect (ASD) or a patent foramen ovale (PFO) associated with systemic embolism without other cause. We report the results of the first 35 patients (19 ASDs, 16 PFOs) in whom transcatheter closure was attempted. Diagnosis and follow-up were based on transesophageal echocardiography in the majority of cases. In all patients the "Sideris buttoned device" was used. A total of 19 patients (13 women) were treated for symptomatic ASD of the secundum type. The mean defect size before the intervention was 17 mm by echocardiography and 24 mm measured by balloon in the catheterization laboratory (stretched diameter) with a reduction to 4 mm after treatment measured by echocardiography. A total of 16 patients (5 women) underwent transcatheter closure of a PFO; 14 patients had had cerebral embolic events and 2 peripheral. During follow-up of 104 patient months, only one patient had a recurrent embolic event. He had at that time no occluder protecting the PFO after early embolization and extraction of the device.