Interventional closure of atrial septal defects with the Solysafe Septal Occluder--preliminary results in children.
BACKGROUND
To report usability, safety, and efficacy of the self-centering Solysafe Septal Occluder for transcatheter closure of secundum type atrial septal defect (ASD) in paediatric patients.


METHODS
Retrospective observational clinical study in two tertiary care centers for congenital heart diseases.


METHODS
First 37 (median age 8.7 years, 68% female) consecutive patients with an ASD stretched diameter up to 22 mm in whom a Solysafe Septal Occluder was used to close a haemodynamically significant ASD.


METHODS
Transcatheter closure of ASD was performed under general anaesthesia with trans-esophageal echo guidance. Stretched diameter of the ASD was assessed by balloon sizing.


METHODS
Rate of success, complete closure rate, and complications (defined as vascular complications, device-related complications such as embolism, thrombus formation, device erosions, infections, and arrhythmia) during follow up.


RESULTS
37 procedures were performed, success rate was 87% (32 of 37 pts.). A missing retroaortic rim was the main reason for device failure. Complete ASD closure rate was 78% immediately in cath lab (25 of 32 pts.), 90% after four weeks (28 of 31 pts.), 94% after three months (29 of 31 pts.), and 100% after six months (20 of 20 pts.). Procedure-related complication was femoral vein thrombosis in one patient.


CONCLUSIONS
The Solysafe Septal Occluder is a feasible, safe, and clinically efficient new device for interventional closure of small to medium sized ASDs less than 23 mm stretched diameter in childhood. Limitations for the Solysafe device are ASDs with absent retroaortic rims and very small children with a body weight<10 kg.
Division of Paediatric Cardiology, University Children's Hospital, Zurich, Switzerland. oliver.kretschmar@kispi.uzh.ch
Oliver
O
Kretschmar
Anca
A
Sglimbea
Ingo
I
Daehnert
Frank Thomas
FT
Riede
Markus
M
Weiss
Walter
W
Knirsch
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D055989:Septal Occluder Device; D012720:Severity of Illness Index; D013927:Thrombosis / Q000175:diagnosis; D016896:Treatment Outcome; D014463:Ultrasonography