[Three-dimensional reconstruction by transesophageal echocardiography of Amplatzer and CardioSEAL prosthetic devices after percutaneous closure and atrial septal defects].
OBJECTIVE
The Amplatzer and cardioSEAL devices are currently used for percutaneous closure of atrial septal defects. The in vivo morphology of these devices is unknown and this is why we sought to describe their geometric profile by three-dimensional echocardiography.


METHODS
Thirteen patients, aged 6 to 18, underwent transcatheter closure of a secundum type atrial septal defect with either the CardioSEAL (n = 8) or the Amplatzer (n = 5) device. Three-dimensional reconstructions of the defect were obtained from transoesophageal bidimensional echocardiographic views.


RESULTS
In the Amplatzer group, the stretched diameter of the defect was larger than in the CardioSEAL group (22 +/- 2 vs 18 +/- 1 mm, p = 0.003), but ehocardiographic surfaces were the same (3.3 +/- 1 vs 3.6 +/- 1 cm2, p = 0.3). The surface of the CardioSEAL device was measured at 4.8 +/- 2 cm2 whereas the Amplatzer's surface was 6.8 +/- 2 cm2 (p = 0.03). The Amplatzer device had a volume of 9 +/- 1 cm3 while the CardioSeal's volume was 3.1 +/- 1 cm3 (p < 0.0001).


CONCLUSIONS
The CardioSEAL device occupies a small volume but it covers less of the septal defect and this may result in a higher incidence of residual shunting. The Amplatzer device almost always occludes the septum, but it tends to bulge into the atria and may cause mechanical complications.
Acar
P
P
Service de cardiologie pédiatrique, hôpital Necker-Enfants malades, Paris.
Bonhoeffer
P
P
Saliba
Z
Z
Aggoun
Y
Y
Bonnet
D
D
Fraisse
A
A
Sidi
D
D
Kachaner
J
J
D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D017548:Echocardiography, Transesophageal; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D016896:Treatment Outcome
Reconstruction tridimensionnelle par échocardiographie transoesophagienne des prothèses Amplatzer et CardioSEAL après fermeture percutanée des communications interauriculaires.