title: Non-surgical closure of atrial septal defect.
abstract: BACKGROUND
  Recently many devices for the transcatheter closure of atrial septal defect (ASD) were developed in the world. Several ASD closing devices, such as Clamshell device, buttoned device, ASD occluder system (ASDOS), Angel Wings, are not fully acceptable from a practical point of view. We reported the clinical trials of transcatheter closure of ASD for Clamshell double umbrella device and Amplatzer septal occluder (ASO) in Japan.
  
  
  METHODS
  Clamshell devices were implanted in 11 patients. Clinical trials for ASO device were carried out in 34 patients in Japan. We reported the results of 17 patients in National Children's Hospital.
  
  
  RESULTS
  Clamshell devices were implanted in all of the patients successfully. Minimal residual shunt was present in four patients (36%), 1 year after the procedure by Doppler color flow imaging. Nine of 11 umbrellas demonstrated fracture of the stainless steel arm. Arm fracture occurred between 1 week and 12 months after implantation. The implantations of ASO device were successful in all of the 17 patients. Sixteen out of 17 (94.1%) had complete closure in the average observation period of 5.5 months. Complications were minimal and transient.
  
  
  CONCLUSIONS
  With respect to complete closure rate, easy manipulation, and complication rate, ASO is the best transcatheter ASD closure device among all the devices at the present time.
authors.affiliation: Division of Cardiology, National Children's Hospital, Setagaya-ku, Tokyo, Japan. aishizawa@nch.go.jp
authors.forename: A
authors.initials: A
authors.lastname: Ishizawa
authors.forename: S
authors.initials: S
authors.lastname: Oho
authors.forename: H
authors.initials: H
authors.lastname: Dodo
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D019736:Prostheses and Implants