TY - JOUR
T1 - Transcatheter closure of atrial septal defects with multiple devices in adults
T2 - Procedural and clinical outcomes
AU - Mahadevan, Vaikom S.
AU - Gomperts, Natalie
AU - Haberer, Kim
AU - Silversides, Candice
AU - Benson, Lee N.
AU - McLaughlin, Peter R.
AU - Horlick, Eric M.
PY - 2009/4/17
Y1 - 2009/4/17
N2 - Objective: This study reports the procedural, short and medium term outcomes in patients receiving multiple implants for device closure of secundum atrial septal defects (ASD). Design and setting: From the database of the Toronto Congenital Cardiac Centre, 36 consecutive patients (mean age 46 ± 15 years; 23 females) received > 1 implant for closure of an interatrial communication. Short term (mean 97 ± 77 days) and medium term (mean 2.5 ± 1.4 years) follow-up data were analyzed. Procedures were performed under intracardiac echo (ICE) and fluoroscopic guidance. Results: The Amplatzer Septal Occluder (ASO™) was implanted in all except one. Thirty-one patients had 2, and 4 patients, 3 ASO™ devices. There were no major adverse events at implantation or on follow-up. Patients with > NYHA class I symptoms fell from 44% to 6% (p < 0.05) at 3 months. Right ventricular (RV) systolic pressure fell from 39 ± 7 to 32 ± 4 mm Hg in the short term (p < 0.05), and to 30 ± 4 mm Hg in the medium term (p < 0.05, compared to baseline) and RV diameters fell from 48 ± 5 to 40 ± 5 (p < 0.05) in the short term and to 38 ± 8 mm (p = ns) in the medium term. Small residual leaks were present in 22% at 3 months and 12% (p < 0.05) at 1 year. Conclusion: Multiple ASD device implants can be safely employed with excellent outcomes. Significant reductions in RV pressure and diameter occur in the short term with a continued trend to benefit.
AB - Objective: This study reports the procedural, short and medium term outcomes in patients receiving multiple implants for device closure of secundum atrial septal defects (ASD). Design and setting: From the database of the Toronto Congenital Cardiac Centre, 36 consecutive patients (mean age 46 ± 15 years; 23 females) received > 1 implant for closure of an interatrial communication. Short term (mean 97 ± 77 days) and medium term (mean 2.5 ± 1.4 years) follow-up data were analyzed. Procedures were performed under intracardiac echo (ICE) and fluoroscopic guidance. Results: The Amplatzer Septal Occluder (ASO™) was implanted in all except one. Thirty-one patients had 2, and 4 patients, 3 ASO™ devices. There were no major adverse events at implantation or on follow-up. Patients with > NYHA class I symptoms fell from 44% to 6% (p < 0.05) at 3 months. Right ventricular (RV) systolic pressure fell from 39 ± 7 to 32 ± 4 mm Hg in the short term (p < 0.05), and to 30 ± 4 mm Hg in the medium term (p < 0.05, compared to baseline) and RV diameters fell from 48 ± 5 to 40 ± 5 (p < 0.05) in the short term and to 38 ± 8 mm (p = ns) in the medium term. Small residual leaks were present in 22% at 3 months and 12% (p < 0.05) at 1 year. Conclusion: Multiple ASD device implants can be safely employed with excellent outcomes. Significant reductions in RV pressure and diameter occur in the short term with a continued trend to benefit.
KW - Atrial septal defect
KW - Congenital heart disease
KW - Multiple defects
KW - Multiple devices
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U2 - 10.1016/j.ijcard.2008.01.027
DO - 10.1016/j.ijcard.2008.01.027
M3 - Article
C2 - 18499287
AN - SCOPUS:63149124945
SN - 0167-5273
VL - 133
SP - 359
EP - 363
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -