Transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder in adult patients: our first clinical experiences [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2008; 36(5): 287-293

Transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder in adult patients: our first clinical experiences

Mehmet Güngör Kaya1, İbrahim Özdoğru1, Ali Baykan2, Ali Doğan1, Tuğrul İnanç1, Orhan Doğdu1, Kazım Üzüm2, Nazmi Narin2, Ramazan Topsakal1, Ali Ergin1, Abdurrahman Oğuzhan1, Namık Kemal Eryol1
1Erciyes University Medical Faculty Department of Cardiology, Kayseri, Turkey
2Erciyes University Medical Faculty Department of Pediatric Cardiology, Kayseri, Turkey


OBJECTIVES
We evaluated short-term results of transcatheter closure of secundum atrial septal defects (ASD) with the Amplatzer septal occluder (ASO) in adults.

STUDY DESIGN
The study included 12 patients (6 males, 6 females; mean age 31±9 years; range 17 to 54 years) who underwent transcatheter ASD closure with the ASO device. Prior to the procedure, the mean pulmonary to systemic flow ratio was 1.9±0.3 (range 1.5 to 2.6). The mean ASD diameter measured by transesophageal echocardiography was 13.9±2.8 mm, the mean stretched diameter of ASD measured by balloon sizing was 15.8±3.4 mm, and the mean ASO device diameter was 17.3±4.7 mm. The patients were evaluated before and six months after the procedure by echocardiography, electrocardiography, and the New York Heart Association (NYHA) functional classification.

RESULTS
Transcatheter ASD closure was successfully performed in 11 patients (91.7%). The mean procedure time was 72 minutes. There was no residual shunt at six months after closure. No serious complications occurred during the procedure and within a mean follow-up of 11.6±2.3 months. Echocardiographic examination at six months showed significant decreases in right ventricular end-diastolic diameter (VEDD) (p=0.007), right/left VEDD ratio (0.003), systolic pulmonary artery pressure (p=0.017), and significant increases in left ventricular ejection fraction (p=0.014) and left VEDD (p=0.005). There were significant decreases in maximum (p=0.003) and minimum (p=0.006) P-wave durations, and P-wave dispersion (p=0.028). The NYHA functional capacity improved significantly from 1.8±0.8 to 1.3±0.5 (p=0.014).

CONCLUSION
Transcatheter closure of secundum ASD with the ASO device is a safe and effective method in adult patients, resulting in significant improvement in clinical symptoms and cardiac dimensions.

Keywords: Adult, echocardiography, transesophageal, heart catheterization/methods; heart septal defects, atrial/therapy.

How to cite this article
Mehmet Güngör Kaya, İbrahim Özdoğru, Ali Baykan, Ali Doğan, Tuğrul İnanç, Orhan Doğdu, Kazım Üzüm, Nazmi Narin, Ramazan Topsakal, Ali Ergin, Abdurrahman Oğuzhan, Namık Kemal Eryol. Transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder in adult patients: our first clinical experiences. Turk Kardiyol Dern Ars. 2008; 36(5): 287-293

Corresponding Author: Mehmet Güngör Kaya, Türkiye
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