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  • 1
    Electronic Resource
    Electronic Resource
    Choice of Device Size and Results of Transcatheter Closure of Atrial Septal Defect Using the Amplatzer Septal Occluder (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of interventional cardiology 15 (2002), S. 0 
    Details
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The impact of device size choice on closure results was analyzed in 138 (101 females, 37 males; age 0.5–84.0 years) consecutive patients who underwent transcatheter closure of the secundum atrial septal defect (ASD) using the Amplatzer septal occluder (ASO). The balloon stretched diameter (SD) of ASD was 19.5 ± 7.2 mm in 123 patients with single defects, and 20.4 ± 6.6 mm for the largest defects in 15 patients with multiple ASDs. The difference (Δ) between ASO size chosen for closure and the stretched diameter of the defect was calculated and divided into groups: Δ (Δ〈2 mm); B (Δ-2.0 to - 0.1 mm); C(Δ=0); D (Δ 0.1–2.0 mm) and E (Δ〉2 mm). The results demonstrated that immediate and 24-hour complete closure rates were significantly higher in patients in groups C and D (P〈0.001). However, at 6-month follow-up, the complete closure rates were similar in patients of groups A-D, while patients of group E had a lower closure rate of75%. The complication rates were similar in all groups. In conclusion, a choice of a device size identical to or within 2 mm larger than the SD of the defect should be used to maximize the closure rates of ASD using the ASO.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8183.2002.tb01105.x
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  • 2
    Electronic Resource
    Electronic Resource
    Role of Intracardiac Echocardiographic Guidance in Transcatheter Closure of Atrial Septal Defects and Patent Foramen Ovale Using the Amplatzer® Device (2003)
    350 Main Street , Malden , MA 02148 , USA . : Blackwell Science Inc
    Journal of interventional cardiology 16 (2003), S. 0 
    Details
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Transesophageal echocardiography (TEE) has been successfully used for guiding transcatheter device closure of secundum atrial septal defect (ASD) and patent foramen ovale (PFO). However, the use of TEE for device closure requires general anesthesia. Experience with intracardiac echocardiographic (ICE) guidance to close ASD and PFO is limited. One hundred eleven patients (76 female/35 male) with secundum ASD (82 patients) and PFO (29 patients) associated with a stroke underwent an attempt of transcatheter closure of their defects under ICE guidance using the new AcuNav® catheter. The median age of patients was 40 years (range 2.5–80.7) and the median weight was 66 kg (range 12.7–128 kg). The median two-dimensional size of secundum defects as measured by ICE was 17 mm (range 3–32 mm). The median balloon stretched diameter of the ASDs was 22 mm (range 4–36 mm). Five patients had more than one defect that required placement of two devices to close the defects. The median Qp/QS ratio for patients with secundum ASD was 2.1 (range 1–18). ICE provided adequate views of the defects and surrounding structures and the various stages of device deployment. All patients had successful device placement, including the patients who received simultaneous two devices with immediate complete closure of the defects in 100 patients, whereas four and seven patients had trivial and small residual shunt, respectively. The median fluoroscopy time was 10.2 minutes (range 3.7–38.4 minutes) and the median total procedure time was 60 minutes (range 28–180 minutes). There were no complications related to the use of the AcuNav catheter. We conclude that ICE provided unique images of the atrial communications and facilitated device closure of secundum ASD and PFO in children and adults. We believe ICE should replace TEE as a guiding imaging tool for ASD and PFO device closure, thus eliminating the need for general anesthesia. (J Interven Cardiol 2003;16:51–62)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8183.2003.08003.x
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    Paper (German National Licenses)
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