title: Transcatheter closure of atrial septal defects with superior-anterior rim deficiency using Amplatzer septal occluder.
abstract: OBJECTIVE
  To evaluate the outcome of transcatheter closure of atrial septal defects (ASD) with superior-anterior (SA) rim deficiency using Amplatzer septal occluder (ASO).
  
  
  METHODS
  Between June 2003 and March 2007, 84 patients with secundum type ASD attempted transcatheter insertion of ASO in our institution. According to the transesophageal echocardiographic findings, patients were divided into two groups: group A, with deficient SA rim (< 3 mm); group B, with sufficient SA rim (> or = 3 mm). There were 43 children and 41 adults (age range, 2.0-79.4 years; mean age, 22.0 +/- 20.2 years). The failure rate, complications and the presence of residual shunt were compared between the two groups.
  
  
  RESULTS
  There were 34 patients in group A and 50 patients in group B. Failure of ASO implantation occurred in six patients, three in each group. One patient had two ASOs implanted for two separate ASDs. Therefore, the study cohort consisted of 78 patients with 79 ASO placed. Among 78 patients with successful implantation, five (6.4%) had persistent small residual shunt during follow-up (range, 1-46 months; mean, 21.6 +/- 12.0 months). There was no statistically significant difference between group A and group B in the procedures failure rate (p = 0.682), complications (p = 1.0) and the presence of residual shunt (p = 0.381) during the follow-up period.
  
  
  CONCLUSIONS
  ASD with deficient SA rim is a common variation. Similar to ASD with sufficient rims, transcatheter closure of secundum type ASD is also effective for ASD with SA rim deficiency.
authors.affiliation: Department of Pediatric Cardiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Huang
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fang
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Shao-Ju
authors.initials: SJ
authors.lastname: Chien
authors.forename: I-Chun
authors.initials: IC
authors.lastname: Lin
authors.forename: Ying-Jui
authors.initials: YJ
authors.lastname: Lin
authors.forename: Chih-Hsien
authors.initials: CH
authors.lastname: Wang
authors.forename: Chi-Di
authors.initials: CD
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D011474:Prosthesis Design