title: Comparison of atrial septal defect closure using amplatzer septal occluder with surgery.
abstract: Our study reports the results of a comparison of closure of atrial septal defect (ASD) surgically with transcatheter closure using the Amplatzer septal occluder. Patients having an ASD and a surgical closure or transcatheter closure between January 1999 and July 2000 were selected. There were 103 patients who had ASD. All 64 patients in group 1 (surgery) had a successful operation, with only 2 patients with a mild residual shunt. There were 39 patients enrolled for transcatheter closure of the ASD (group 2). Four patients were excluded initially. The median age for group 1 was 25 years (range 2.3-64 years) compared to 11.7 years (range 2-69 years) in group 2 (p = 0.035). In group 1, the mean ASD diameter measured was 28.4 +/- 10.2 mm compared to 23.4 +/- 5.7 mm in group 2 (p = 0.003). In 29 patients, devices were deployed with sizes from 10 mm to 30 mm (median 24 mm). Three patients were excluded because a larger device (>30 mm) was not available and devices were not successfully deployed in another 3 patients. One patient had a device embolized into the right ventricle (surgical removal and closure of the ASD). Complications occurred in 13 patients in group 1 and 4 patients in group 2. Complete occlusion occurred in 27 of 28 group 2 patients (96.4%) during the follow-up period (10.2 +/- 5.4 months). The Amplatzer septal occluder is a new device for closure of different-sized ASDs. The intermediate-term follow-up demonstrated excellent closure results. The benefit for each patient was demonstrated in less morbidity and less time spent in the hospital.
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Durongpisitkul
authors.forename: J
authors.initials: J
authors.lastname: Soongswang
authors.forename: D
authors.initials: D
authors.lastname: Laohaprasitiporn
authors.forename: A
authors.initials: A
authors.lastname: Nana
authors.forename: S
authors.initials: S
authors.lastname: Sriyoschati
authors.forename: S
authors.initials: S
authors.lastname: Ponvilawan
authors.forename: T
authors.initials: T
authors.lastname: Subtaweesin
authors.forename: C
authors.initials: C
authors.lastname: Kangkagate
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D014463:Ultrasonography