title: Transcatheter closure of interatrial communications with Amplatzer device: results, unfulfilled attempts and special considerations in children and adolescents.
abstract: OBJECTIVE
  We report our clinical experience with the Amplatzer device in transcatheter closure of 80 atrial septal defects (ASD) in children.
  
  
  METHODS
  Among 99 patients (mean age: 7.2+/-3.8 years) with ASD selected by transthoracic echocardiography, procedures were performed in 80 patients under general anesthesia with fluoroscopic and transesophageal echocardiographic (TEE) guidance. Optimal device size was selected after stretched balloon sizing of the ASD's. The patients were discharged at 24 hours after an evaluation with X-ray, electrocardiography and echocardiography.
  
  
  RESULTS
  The mean follow-up period (FUP) was 38+/-14 months. Mean ASD size was 11.5+/-3.7 mm at TEE (stretched size: 17.6+/-3.9 mm). The mean size of the device was 18.6+/-4.0 mm. Procedure and fluoroscopy time were 52.1+/-17.8 minutes and 11.0+/-4.9 minutes, respectively. Immediately after the procedure 35 patients (43.8%) had residual shunts. Trivial shunt remained in only 2 of them (2.5%) after FUP. None of the patients had major complications. Minor and transient rhythm abnormalities were observed in 5 patients and trivial mitral regurgitation was seen in 6 patients.
  
  
  CONCLUSIONS
  Amplatzer is an effective and safe device for transcatheter closure of ASD especially in pediatric patients.
authors.affiliation: Department of Pediatric Cardiology, Medical Faculty, Hacettepe University, 06100 Ankara, Turkey. alpayceliker@hotmail.com
authors.forename: Alpay
authors.initials: A
authors.lastname: Celiker
authors.forename: Süheyla
authors.initials: S
authors.lastname: Ozkutlu
authors.forename: Tevfik
authors.initials: T
authors.lastname: Karagöz
authors.forename: Canan
authors.initials: C
authors.lastname: Ayabakan
authors.forename: Arman
authors.initials: A
authors.lastname: Bilgiç
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016896:Treatment Outcome