[Criteria for percutaneous non-closure of interatrial communications of the ostium secundum type by the Amplatzer septal occluder].
The aim of the study is to recognise the criteria preventing the percutaneous closure of an interatrial communication of the ostium secundum type for the Amplatzer septal occluder device. From January 1999 to December 2000, 121 consecutive patients with an average age of 24.8 +/- 19 years affected with an interatrial communication of the ostium secundum type underwent echocardiographic examination with transthoracic Doppler to evaluate the maximal diameter of the communication, the border dimensions, and the length of the interatrial septum; 92.5% of them underwent haemodynamic investigation to evaluate the shunt and the stretched diameter. Comparison of the umbrella group averages with the surgical group was performed by the Student test, and the frequencies by the Chi 2 test. ROC curves were drawn for the numeric parameters. After these 2 examinations, 68 patients underwent an attempt at percutaneous closure with 61 successful (84.7%) and 53 had a surgical closure straight off. The surgical group was younger, with a more significant shunt and a wider communication. The criteria for non-closure apart from abnormal pulmonary venous reflux were: insufficient border (59% of cases), diameter too wide (16%), multiperforate septum (16%) and insufficient septum length (9%). Percutaneous closure could be performed in 2/3 of interatrial communications without abnormal pulmonary venous reflux. Candidates for surgery were younger, with a more significant shunt and a wider diameter. In retrospect 8 patients of the surgical group could have had percutaneous closure and 7 patients of the umbrella group could have been sent straight for surgery.
Satsou
D
D
Service de maladies cardiovasculaires infantiles et congénitales, hôpital cardiologique, 59037 Lille.
Godart
F
F
Vincentelli
A
A
Francart
C
C
Jegou
B
B
Fabre
O
O
Devos
P
P
Prat
A
A
Rey
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000473:pathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler