title: Choice of device size and results of transcatheter closure of atrial septal defect using the amplatzer septal occluder.
abstract: 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 (delta) between ASO size chosen for closure and the stretched diameter of the defect was calculated and divided into groups: A (delta < -2 mm); B (delta -2.0 to -0.1 mm); C (delta = 0); D (delta 0.1-2.0 mm) and E (delta > 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 of 75%. 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.
authors.affiliation: Section of Pediatric Cardiology, Department of Pediatrics, University of Chicago Children's Hospital, Pritzker School of Medicine, Chicago, Illinois, USA.
authors.forename: Zhong-Dong
authors.initials: ZD
authors.lastname: Du
authors.forename: Qi-Ling
authors.initials: QL
authors.lastname: Cao
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rhodes
authors.forename: Mary
authors.initials: M
authors.lastname: Heitschmidt
authors.forename: Ziyad M
authors.initials: ZM
authors.lastname: Hijazi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D020878:Device Removal; D004452:Echocardiography; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome