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Erschienen in: Pediatric Cardiology 3/2008

01.05.2008 | Original Article

Cribriform Amplatzer Device Closure of Fenestrated Atrial Septal Defects: Feasibility and Technical Aspects

verfasst von: Mohammed Numan, Amal El Sisi, Magdi Tofeig, Salwa Gendi, Tohami Tohami, Howaida G. El-Said

Erschienen in: Pediatric Cardiology | Ausgabe 3/2008

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Abstract

Fenestrated atrial septal defects (F-ASDs) may pose a challenge to device closure; recently, a cribriform device with a minimal connecting intrawaist diameter and large, equal left- and right-sided discs has been designed to cover more than one adjacent defect. This study demonstrates the feasibility and technical aspects of closing F-ASDs using this new device. Sixteen patients between August 2003 and January 2006 were included in this study. The inclusion criterion was the presence of a F-ASD diagnosed by transesophageal echocardiography. One of the three available cribriform ASD device sizes (18, 25, or 35 mm) was implanted. Patients were followed for at least 1 year after the procedure. Thirteen patients had successful cribriform ASD device implantation (median age and weight, 12.5 years and 36 kg, respectively). Ten patients (62%) had an associated atrial septal aneurysm. The mean procedure time was 75.6 ± 28.5 min and the mean fluoroscopy time 14.8 ± 6.3 min. The RVEDD was significantly reduced, from a mean of 24.2 mm to 21.0 (p < 0.05). One patient developed atrial tachycardia requiring cardioversion during the procedure. There were no embolic events, heart block, or mortality. Complete closure was 10 of 13 (77 %) the next day and 12 of 13 (92%) at 6 and 12 months. We conclude that the cribriform Amplatzer device can be successfully and safely used in patients with F-ASDs. Complete closure may take up to 6 months.
Literatur
1.
Zurück zum Zitat Adams HP (2004) Patent foramen ovale: paradoxical embolism and paradoxical data. Mayo Clin Proc 79:15–20PubMed Adams HP (2004) Patent foramen ovale: paradoxical embolism and paradoxical data. Mayo Clin Proc 79:15–20PubMed
2.
Zurück zum Zitat Aeschbacher BC, Chatterjee T, Meier B (2000) Transesophageal echocardiography to evaluate success of transcatheter closure of secundum atrial septal defects in adults using the buttoned device. Mayo Clinic Proc 75:913–920CrossRef Aeschbacher BC, Chatterjee T, Meier B (2000) Transesophageal echocardiography to evaluate success of transcatheter closure of secundum atrial septal defects in adults using the buttoned device. Mayo Clinic Proc 75:913–920CrossRef
3.
Zurück zum Zitat Berdat PA, Chatterjee T, Pfammatter JP, et al. (2000) Surgical management of complications after transcatheter closure of an atrial septal defect or patient foramen ovale. J Thorac Cardiovasc Surg 120:1034–1039PubMedCrossRef Berdat PA, Chatterjee T, Pfammatter JP, et al. (2000) Surgical management of complications after transcatheter closure of an atrial septal defect or patient foramen ovale. J Thorac Cardiovasc Surg 120:1034–1039PubMedCrossRef
4.
Zurück zum Zitat Berger F, Ewert P, Bjornstad PG, et al. (1999) Transcatheter closure as standard treatment for most interartial defects: experience in 200 patients treated with amplatzer septal occluder. Cardiol Young 9:468–473PubMed Berger F, Ewert P, Bjornstad PG, et al. (1999) Transcatheter closure as standard treatment for most interartial defects: experience in 200 patients treated with amplatzer septal occluder. Cardiol Young 9:468–473PubMed
5.
Zurück zum Zitat Berger F, Vogel M, Alexi-Meskishvili V, et al. (1999) Comparison of results and complications of surgical and Amplatzer device closure of atrial septal defects. J Thorac Cardiovasc Surg 118:674–680PubMedCrossRef Berger F, Vogel M, Alexi-Meskishvili V, et al. (1999) Comparison of results and complications of surgical and Amplatzer device closure of atrial septal defects. J Thorac Cardiovasc Surg 118:674–680PubMedCrossRef
6.
Zurück zum Zitat Cao Q, Radtke W, Berger F, et al. (2000) Transcatheter closure of multiple atrial septal defects. Initial results and value of two and three dimensional transoesophageal echocardiography. Eur Heart J 21:941–947PubMedCrossRef Cao Q, Radtke W, Berger F, et al. (2000) Transcatheter closure of multiple atrial septal defects. Initial results and value of two and three dimensional transoesophageal echocardiography. Eur Heart J 21:941–947PubMedCrossRef
7.
Zurück zum Zitat Carano N, Hagler DJ, Agnetti A, et al. (2001) Device closure of fenestrated atrial septal defects: use of single Amplatz atrial septal occluder after balloon atrial septostomy to create a single defect. Cath Cardiovasc Interv 52:203–207CrossRef Carano N, Hagler DJ, Agnetti A, et al. (2001) Device closure of fenestrated atrial septal defects: use of single Amplatz atrial septal occluder after balloon atrial septostomy to create a single defect. Cath Cardiovasc Interv 52:203–207CrossRef
8.
Zurück zum Zitat Carminati M, Butera G, et al. (2002) Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 39:1061–1065PubMedCrossRef Carminati M, Butera G, et al. (2002) Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 39:1061–1065PubMedCrossRef
9.
Zurück zum Zitat Carminati M, Giusti S, Hausdorf G, et al. (2000) A European multicentric experience using the CardioSEAL and Starflex double umbrella devices to close interatrial communications holes with the oval fossa. Cardiol Young 10:519–526PubMedCrossRef Carminati M, Giusti S, Hausdorf G, et al. (2000) A European multicentric experience using the CardioSEAL and Starflex double umbrella devices to close interatrial communications holes with the oval fossa. Cardiol Young 10:519–526PubMedCrossRef
10.
Zurück zum Zitat Chan KC, Godman MJ, Walsh K, et al. (1999) Transcatheter closure of artial septal defects and interatrial communications with a new self expanding nitinol double disc device (Amplatzer septal occluder): multicentre UK experience. Heart 82:300–306PubMed Chan KC, Godman MJ, Walsh K, et al. (1999) Transcatheter closure of artial septal defects and interatrial communications with a new self expanding nitinol double disc device (Amplatzer septal occluder): multicentre UK experience. Heart 82:300–306PubMed
11.
Zurück zum Zitat Chessa M, Carminati M, Butera G, et al. (2002) Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 39:1061–1065PubMedCrossRef Chessa M, Carminati M, Butera G, et al. (2002) Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 39:1061–1065PubMedCrossRef
12.
Zurück zum Zitat Cowley CG, Lloyd TR, Bove EL, et al. (2001) Comparison of results of closure of secundum atrial septal defect by surgery versus Amplatzer septal occluder. Am J Cardiol 88:589–591PubMedCrossRef Cowley CG, Lloyd TR, Bove EL, et al. (2001) Comparison of results of closure of secundum atrial septal defect by surgery versus Amplatzer septal occluder. Am J Cardiol 88:589–591PubMedCrossRef
13.
Zurück zum Zitat Dhilon R, Josen M, Henien M, et al. (2002) Transcatheter closure of atrial septal defect preserves right ventricular. Heart 87:461–465CrossRef Dhilon R, Josen M, Henien M, et al. (2002) Transcatheter closure of atrial septal defect preserves right ventricular. Heart 87:461–465CrossRef
14.
Zurück zum Zitat Du ZD, Hijazi ZM, Kleinman CS, et al. (2002) Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicentre nonrandomized trial. J Am Coll Cardiol 39:1936–1944 Du ZD, Hijazi ZM, Kleinman CS, et al. (2002) Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicentre nonrandomized trial. J Am Coll Cardiol 39:1936–1944
15.
Zurück zum Zitat Fischer G, Stieh J, Uebing A, et al. (2003) Experience with transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder: a single center study in 236 consecutive patients. Heart 89:199–204PubMedCrossRef Fischer G, Stieh J, Uebing A, et al. (2003) Experience with transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder: a single center study in 236 consecutive patients. Heart 89:199–204PubMedCrossRef
16.
Zurück zum Zitat Fischer G, Kramer HH, et al. (1999) Transcatheter closure of secundum atrial septal defects with the new self centric Amplatzer septal occluder. Eur Heart J 20:541PubMedCrossRef Fischer G, Kramer HH, et al. (1999) Transcatheter closure of secundum atrial septal defects with the new self centric Amplatzer septal occluder. Eur Heart J 20:541PubMedCrossRef
17.
Zurück zum Zitat Formigari R, Di Donato RM, Mazzera E, et al. (2001) Minimally invasive or interventional repair of atrial septal defect in children: experience in 171 cases and comparison with conventional strategies. J Am Coll Cardiol 37:1707–1712PubMedCrossRef Formigari R, Di Donato RM, Mazzera E, et al. (2001) Minimally invasive or interventional repair of atrial septal defect in children: experience in 171 cases and comparison with conventional strategies. J Am Coll Cardiol 37:1707–1712PubMedCrossRef
18.
Zurück zum Zitat Galal MO, Wobst A, Halees Z, et al. (1994) Peri-operative complications following surgical closure of artial septal defect type II in 232 patients—a baseline study. Eur Heart J 15:1381–1384PubMed Galal MO, Wobst A, Halees Z, et al. (1994) Peri-operative complications following surgical closure of artial septal defect type II in 232 patients—a baseline study. Eur Heart J 15:1381–1384PubMed
19.
Zurück zum Zitat Hausdorf G, Kaulitz R, Paul T, et al. (1999) Transcatheter closure of artial septal defect with a new flexible, self-centering device (the STARFlex Occluder). Am J Cardiol 84:1113–1116PubMedCrossRef Hausdorf G, Kaulitz R, Paul T, et al. (1999) Transcatheter closure of artial septal defect with a new flexible, self-centering device (the STARFlex Occluder). Am J Cardiol 84:1113–1116PubMedCrossRef
20.
Zurück zum Zitat Hijazi ZM, Cao Q, Patel HT, et al. (2000) Transesophageal echocardiographic results of catheter closure of atrial septal defect in children and adults using the amplatzer device. Am J Cardiol 85:1387–1390PubMedCrossRef Hijazi ZM, Cao Q, Patel HT, et al. (2000) Transesophageal echocardiographic results of catheter closure of atrial septal defect in children and adults using the amplatzer device. Am J Cardiol 85:1387–1390PubMedCrossRef
21.
Zurück zum Zitat Kaulitz R, Paul T, Hausdorf G (1998) Extending the limits of transcatheter closure of atrial septal defects with the double umbrella device (CardioSeal). Heart 80:54–59PubMed Kaulitz R, Paul T, Hausdorf G (1998) Extending the limits of transcatheter closure of atrial septal defects with the double umbrella device (CardioSeal). Heart 80:54–59PubMed
22.
Zurück zum Zitat Lezo JS, Medina A, Pan M, et al. (2000) Transcatheter occlusion of complex atrial septal defects. Cath Cardiovasc Interv 51:33–41CrossRef Lezo JS, Medina A, Pan M, et al. (2000) Transcatheter occlusion of complex atrial septal defects. Cath Cardiovasc Interv 51:33–41CrossRef
23.
Zurück zum Zitat Pedra CA, Fontes-Pedra SR, Esteves CA, et al. (1998) Multiple atrial septal defects and patent ductus arteriosus. Successful outcome using two Amplatzer setal occluders and Gianturco coils. Cath Cardiovasc Diagn 45:257–259CrossRef Pedra CA, Fontes-Pedra SR, Esteves CA, et al. (1998) Multiple atrial septal defects and patent ductus arteriosus. Successful outcome using two Amplatzer setal occluders and Gianturco coils. Cath Cardiovasc Diagn 45:257–259CrossRef
24.
Zurück zum Zitat Pedra CA, Pihkala J, Lee K-J, et al. (2000) Transcatheter closure of artial septal defect using the Cardio-seal implant. Heart 84:320–326PubMedCrossRef Pedra CA, Pihkala J, Lee K-J, et al. (2000) Transcatheter closure of artial septal defect using the Cardio-seal implant. Heart 84:320–326PubMedCrossRef
25.
Zurück zum Zitat Perry YY, Triedman JK, Gauvreau K, et al. (2000) Sudden death in patients after transcatheter device implantation for congenital heart disease. Am J Cardiol 85:992–995PubMedCrossRef Perry YY, Triedman JK, Gauvreau K, et al. (2000) Sudden death in patients after transcatheter device implantation for congenital heart disease. Am J Cardiol 85:992–995PubMedCrossRef
26.
Zurück zum Zitat Prieto LR, Foreman CK, Cheatham JP, et al. (1996) Intermediate-term outcome of transcatheter secundum atrial septal defect closure using the Bard clamshell septal umbrella. Am J Cardiol 78:1310–1312PubMedCrossRef Prieto LR, Foreman CK, Cheatham JP, et al. (1996) Intermediate-term outcome of transcatheter secundum atrial septal defect closure using the Bard clamshell septal umbrella. Am J Cardiol 78:1310–1312PubMedCrossRef
27.
Zurück zum Zitat Roa PS, Berger F, Rey C, et al. (2000) Results of transvenous occlusion of secundum atrial septal defects with fourth generation buttoned device: comparison with first, second and third generation devices. International Buttoned Device Trial Group. J Am Coll Cardiol 36:583–592CrossRef Roa PS, Berger F, Rey C, et al. (2000) Results of transvenous occlusion of secundum atrial septal defects with fourth generation buttoned device: comparison with first, second and third generation devices. International Buttoned Device Trial Group. J Am Coll Cardiol 36:583–592CrossRef
28.
Zurück zum Zitat Rome JJ, Keane JF, Perry SB, et al. (1990) Double-umbrella closure of artial septal defects: initial clinical applications. Circulation 82:751–758PubMed Rome JJ, Keane JF, Perry SB, et al. (1990) Double-umbrella closure of artial septal defects: initial clinical applications. Circulation 82:751–758PubMed
29.
Zurück zum Zitat Schenck MH, Sterba R, Foreman CK, et al. (1995) Improvement in noninvasive electrophysiologic findings in children after transcatheter artial septal defect closure. Am J Cardiol 76:695–698PubMedCrossRef Schenck MH, Sterba R, Foreman CK, et al. (1995) Improvement in noninvasive electrophysiologic findings in children after transcatheter artial septal defect closure. Am J Cardiol 76:695–698PubMedCrossRef
30.
Zurück zum Zitat Sub C, Tajik AJ, Seward JB, et al. (1985) Surgical repair of uncomplicated atrial septal defect without “routine” preoperative cardiac catheterization. J Am Coll Cardiol 6:49–54CrossRef Sub C, Tajik AJ, Seward JB, et al. (1985) Surgical repair of uncomplicated atrial septal defect without “routine” preoperative cardiac catheterization. J Am Coll Cardiol 6:49–54CrossRef
31.
Zurück zum Zitat Szkutnik M, et al. (2004) Transcatheter closure of double atrial septal defects with a single Amplatzer device. Cath Cardiovasc Interv 61(2):237–241CrossRef Szkutnik M, et al. (2004) Transcatheter closure of double atrial septal defects with a single Amplatzer device. Cath Cardiovasc Interv 61(2):237–241CrossRef
32.
Zurück zum Zitat Thanopoulos BD, Laskari CV, Tsousis GS, et al. (1998) Closure of artial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol 31:1110–1116PubMedCrossRef Thanopoulos BD, Laskari CV, Tsousis GS, et al. (1998) Closure of artial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol 31:1110–1116PubMedCrossRef
33.
Zurück zum Zitat Thompson JDR, Aburawi EH, Watterson KG, et al. (2002) Surgical and transcatheter (Amplatzer) closure of artial septal defect: a prospective comparison of results and cost. Heart 87:466–469CrossRef Thompson JDR, Aburawi EH, Watterson KG, et al. (2002) Surgical and transcatheter (Amplatzer) closure of artial septal defect: a prospective comparison of results and cost. Heart 87:466–469CrossRef
34.
Zurück zum Zitat Visconti KJ, Bichell DP, Jonas RA, et al. (1999) Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation 100 (Suppl):145–150 Visconti KJ, Bichell DP, Jonas RA, et al. (1999) Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation 100 (Suppl):145–150
35.
Zurück zum Zitat Wang JK, Tsai SK, Wu MH, Lin MT, Lue HC (2004) Short and intermediate results of transcatheter closure of atrial septal defect with the Amplazer septal occluder. Am Heart J 148:511–517PubMedCrossRef Wang JK, Tsai SK, Wu MH, Lin MT, Lue HC (2004) Short and intermediate results of transcatheter closure of atrial septal defect with the Amplazer septal occluder. Am Heart J 148:511–517PubMedCrossRef
36.
Zurück zum Zitat Zanchetta M, et al. (2005) Catheter closure of perforated secundum atrial septal defect under intracardiac echocardiographic guidance using a single amplatzer device: feasibility of a new method. J Invas Cardiol 17(5):262–265 Zanchetta M, et al. (2005) Catheter closure of perforated secundum atrial septal defect under intracardiac echocardiographic guidance using a single amplatzer device: feasibility of a new method. J Invas Cardiol 17(5):262–265
Metadaten
Titel
Cribriform Amplatzer Device Closure of Fenestrated Atrial Septal Defects: Feasibility and Technical Aspects
verfasst von
Mohammed Numan
Amal El Sisi
Magdi Tofeig
Salwa Gendi
Tohami Tohami
Howaida G. El-Said
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
Pediatric Cardiology / Ausgabe 3/2008
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-007-9079-x

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