title: Transcatheter closure of secundum atrial septal defects with the Amplatzer septal occluder in adults and children-follow-up closure rates, degree of mitral regurgitation and evolution of arrhythmias.
abstract: OBJECTIVE
  To report the results of transcatheter atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO) from the single centre providing interventions for congenital heart disease in New Zealand.
  
  
  METHODS
  A single centre retrospective review of all patients 1997-2004 inclusive, undergoing planned transcatheter ASD closure was undertaken. Implantation success, complications and latest patient follow-up are described.
  
  
  RESULTS
  Percutaneous ASD closure was planned in 227 adults and children. (55% had additional medical co-morbidities.) The mean ASD size was 22+/-6 mm, and device size ranged from 5 to 40 mm. Closure was successful in 93%, unsuccessful in 5% and not attempted in 2%. There were two device embolisations, one immediately post-release and one within 24h. Minor procedural complications occurred in 5% of patients. There were no cases of suspected or proven device erosion. Ninety-two percent had documented follow-up beyond 6 months. At latest follow-up the closure rate was 98.5%. There was no significant change in the degree of mitral regurgitation. Sixteen of 24 with pre-closure arrhythmias resolved while 10 remained in atrial fibrillation. Six patients developed new arrhythmias but these were well controlled medically.
  
  
  CONCLUSIONS
  There is a high implantation and closure rate using transcatheter ASD closure with the Amplatzer septal occluder in children and adults avoiding the need for cardiac surgery. Follow-up at one year shows there is no progression of mitral regurgitation, and supraventricular arrhythmias have usually resolved.
authors.affiliation: Green Lane Cardiovascular Service and Starship Children's Hospital, Auckland, New Zealand. nigelw@adhb.govt.nz
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Wilson
authors.forename: Joanna
authors.initials: J
authors.lastname: Smith
authors.forename: Bundit
authors.initials: B
authors.lastname: Prommete
authors.forename: Clare
authors.initials: C
authors.lastname: O'Donnell
authors.forename: Tom L
authors.initials: TL
authors.lastname: Gentles
authors.forename: Peter N
authors.initials: PN
authors.lastname: Ruygrok
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies