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. ①.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; ②. 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; ③.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.