Multislice computed tomographic findings in symptomatic patients after amplatzer septal occluder device implantation.
BACKGROUND
Complications of transcatheter closure of atrial septal defects (ASDs) include pericardial effusion, tamponade, and even death. Transthoracic echocardiography in the adult is often limited by poor acoustic windows that lead to incomplete device assessment. Advances in multislice computed tomography (MSCT) provide an alternative modality to assess the anatomy of the Amplatzer Septal Occluder (ASO) device.


OBJECTIVE
The purpose of this study was to determine the feasibility of MSCT in providing anatomic information in patients with persistent or recurrent symptoms after transcatheter closure of ASDs with ASO devices.


METHODS
A retrospective analysis of adult patients who underwent ASO device implantation with subsequent MSCT imaging as a result of symptoms from June 2006 to May 2007 was performed. Data analysis included age, gender, size of ASO device, relationship of the device to surrounding structures, symptoms, and the length of time between device implantation and onset of symptoms.


RESULTS
Eleven patients were identified with a mean age of 41 years. Patients presented with symptoms 1 week to 2.4 years after implantation. ASO size ranged from 8 to 36 mm. MSCT provided detailed information in all 11 cases regarding anatomic location of the device with respect to surrounding structures. Nonobstructive coronary plaque disease was identified in one patient. Two patients had pericardial effusions.


CONCLUSIONS
Cardiac symptoms after ASO implant deserve thorough investigation. MSCT is feasible in the assessment of such patients and offers a unique assessment of the device to surrounding anatomic structures and should be considered as a useful adjunct to echocardiography in symptomatic patients.
Zaidi
Ali N
AN
Department of Internal Medicine, Division of Cardiovascular Medicine, The Ross Heart Hospital, The Ohio State University, Columbus, Ohio, USA.
Cheatham
John P
JP
Raman
Subha V
SV
Cook
Stephen C
SC
D000328:Adult; D016208:Databases, Factual; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D019736:Prostheses and Implants / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult