title: Factors related to successful transcatheter closure of atrial septal defects using the Amplatzer septal occluder.
abstract: The Amplatzer septal occluder (ASO) is used for transcatheter closure of atrial septal defects (ASDs). This study aimed to determine the factors influencing successful closure with the ASO. A retrospective analysis of 69 patients who underwent transcatheter ASD occlusion between 2003 and 2007 was performed. The ASO was successfully implanted during 67 (97%) of 69 procedures. A major adverse event occurred for 6 patients (9%), and 13 patients (19%) experienced a minor adverse event. The outcome for 53 cases (77%) was a composite clinical success. Patient age (p = 0.191) and consultant experience (p = 0.270) were not important factors in successful ASD occlusion. However, patient weight (p = 0.031), diameter of the defect (p = 0.030), device size (p = 0.044), aortic rim size (p = 0.002), and device/defect ratio (p < 0.001) all were significant factors. Complications were significantly more likely for patients whose device/defect ratio was <1.125 (loose) or > or = 1.333 (tight) (p < 0.001). The device/defect ratio may provide a clinically useful tool with the potential to predict patients likely to experience an adverse event as a result of transcatheter ASD occlusion. A larger sample would enable refinement of the device/defect ratio and provide a more robust prediction of success.
authors.affiliation: Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & Thomas' NHS Foundation Trust, London SE1 7EH, UK.
authors.forename: Namrata
authors.initials: N
authors.lastname: Rastogi
authors.forename: Nigel Charles
authors.initials: NC
authors.lastname: Smeeton
authors.forename: Shakeel Ahmed
authors.initials: SA
authors.lastname: Qureshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055989:Septal Occluder Device; D018709:Statistics, Nonparametric; D016896:Treatment Outcome