APPLYING AMPLATZER DEVICE TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECTS

Wang HSh, Qian MY, Zhang ZhW, et al.

Guangdong Cardiovascular Institute, Guangzhou 510100, China

 

Objectives: To evaluate the clinical effectiveness of the transcatheter closure on closing the secundum atrial septal defects (ASD) with Amplatzer device.

Methods: Seventy-one children (male 33 and 38 femal) with secundum ASD were undergone the transcatheter closure of ASD by using Amplatzer device from Aug.1998 to Sep.2000. The patients’ age was from 2 to 15 years old (average 7±4). The body weight was from 10 to 50 Kg (average 22±11).The Echo technique was used to detect and measured the defect of patients. Monitored by the Echo and X-ray the balloon stretch diameter of the ASD was recorded. According to the stretch diameter of ASD the size of device was selected. All patients have been followed up.

Results: All cases were successful. The rate of the residual shunts was 2.8%. The complication was seldom. The diameter of ASD measured by the trans thoracic echo (TTE) showed a better correlation to the diameter of ASD measured by the balloon stretch. The stretch diameter was estimated by a formula , that is 6.54+0.97×the diameter of ASD measured by TTE .

Conclusion: The suggested the indications of transcatheter closure in ASD’ are as follows.  .The appropriate age is above 2 years old, the weight above 12 Kg, the diameter of ASD<30mm and the defect belong to simple secundum atrial septal defect; . The diameter of Internal Atrial septum (IAS) is long enough to allow device standing, and the diameter of IAS >the stretch diameter of ASD + 14 mm; .The distance between the rim of  ASD and import cardiac structures , such as mitral valve, superior and inferior venous, and the posterior edge should be >5mm . The Echo could help to select the patients and supervise the closure of ASD. The trans esophageal echo (TEE) is very helpful during the procedure. Although transcatheter closure of secundum atrial septal defects with Amplatzer devices has been successfully employed, this patient should be long tern followed up.

 

 
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