title: [Correction of the perpendicular positioning of the Amplatzer device during closure of an ostium secundum atrial septal defect].
abstract: OBJECTIVE
  Ostium secundum atrial septal defects require closure. Echocardiographic studies have reported that, in 7% of cases, the Amplatzer occluder is orientated perpendicular to the rim of the defect. This article describes the use of an ancillary technique involving a balloon catheter that enables the Amplatzer device to be positioned transversely.
  
  
  METHODS
  We report six patients with an ostium secundum atrial septal defect in whom echocardiographic imaging showed that the Amplatzer device was positioned perpendicular to the rim of the defect. To correct the device's orientation, we used an ancillary maneuver that involved placing a balloon catheter at the device's lower edge, thereby inducing it to adopt a transverse position and undergo successful implantation.
  
  
  RESULTS
  In all cases, the ancillary balloon catheter technique enabled the device to adopt the correct transverse orientation, thereby facilitating successful implantation.
  
  
  CONCLUSIONS
  The ancillary balloon catheter technique is useful for ensuring that Amplatzer devices adopt a transverse orientation when echocardiography shows the device to be persistently orientated perpendicular to the rim of the septal defect.
authors.affiliation: Laboratorio de Intervencionismo en Cardiopatías Congénitas, Centro Médico Nacional 20 de Noviembre, ISSSTE, México DF, México.
authors.forename: Ramón A
authors.initials: RA
authors.lastname: Flores
authors.forename: Antonio
authors.initials: A
authors.lastname: Salgado
authors.forename: Sandra P
authors.initials: SP
authors.lastname: Antúnez
authors.forename: Humberto
authors.initials: H
authors.lastname: García
authors.forename: José L
authors.initials: JL
authors.lastname: Aceves
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D019919:Prosthesis Implantation