[Factors influencing the choice of atrial septal occluder for transcatheter closure of secundum atrial septal defects].
OBJECTIVE
To analyze factors influencing the choice of atrial septal occluder (ASO) for transcatheter closure of patients with secundum atrial septal defect (ASD).


METHODS
A total of 1114 ASD patients [388 males, aged from 2 to 75 years, mean age (26.3 +/- 17.0) years] were enrolled. Patients were divided to adult (> 14 years, mean 34.4 years, n = 779) and child (< or = 14 years, mean 7.3 years, n = 335) groups. ASD size in different ultrasound cross-sections was determined by transthoracic echocardiography (TTE). ASO size was chosen on the basis of the maximum diameter of the defect (MD). Defect-shapes and rim lengths of ASD, the difference choice of ASO in the two groups were compared.


RESULTS
MD of the defects ranged from 5 to 40 mm [mean (19.7 +/- 7.8) mm]. ASD was successfully occluded in 1085 out of 1114 patients (97.4%). Occluder size ranged from 6 to 46 mm [mean (25.8 +/- 8.9) mm] and the difference between occluder size and MD ranged from 2 to 10 mm [mean (6.1 +/- 3.4) mm, ASO/MD ratio 1.3:1]. Though the diameter of the defect was similar between the 2 groups, the size of occluder was significantly larger in adult group than that in child group (ASO/MD ratio 1.1 - 1.6:1 vs. 1.2 - 1.8:1, P < 0.05). MD was significantly correlated with ASO in both groups (r = 0.911 and r = 0.944 in adults and child groups, respectively, all P < 0.01). The size and increment of the occluder used in patients with deficient anterior rims was significantly bigger than patients with sufficient anterior rims (P < 0.01).


CONCLUSIONS
The maximum diameter of the defect was the major determinant for selecting occluder size and choice of occluder size was also influenced by patient age, defect-shape and defect rim for transcatheter closure of secundum ASD.
Department of Cardiology, First Affiliated Hospital, Medical College of Xi'an Jiao-tong University, Xi'an 710061, China. zys2889@sina.com
Yu-Shun
YS
Zhang
Bei-di
BD
Lan
Huan
H
Li
Xu-Mei
XM
He
Zheng-Xue
ZX
Dai
Hai-Chang
HC
Wang
Jun
J
Zhang
Jun
J
Li
Ya-Juan
YJ
DU
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011474:Prosthesis Design; D055989:Septal Occluder Device; D055815:Young Adult