title: Percutaneous device closure for secundum-type atrial septal defect: short and intermediate-term results.
abstract: BACKGROUND
  Device closure of an isolated secundum type atrial septal defect (ASD) has been used as an alternative method for open surgical closure with comparable success and lower morbidity. In this study we evaluated the procedural success and mid-term follow-up results of percutaneous closure of secundum ASD with an Amplatzer™Septal Occluder(ASO) device or a Figula ASD occluder device.
  
  
  METHODS
  From June 2001 to January 2009, 74 consecutive patients were scheduled for percutaneous device closure in two centers in Tehran, Iran. All patients had a stretched defect diameter of 30mm or less. After using a sizing balloon to measure the stop-flow diameter, device implantation was performed under the guidance of a trans-esophageal echocardiography (TEE).The size was generally 1 - 2 mm larger than the stretched diameter. Patients were followed for an average of 11 ±4 months.
  
  
  RESULTS
  The median stretched diameter of the defect was 20.7±4.8 mm (range: 8 - 30 mm).A total of 73 devices were used in this study. Device closure was successful in 72 (97.2%) out of 74 patients. Repositioning of the device was required in one patient. Major complications(including significant residual shunt and device embolization) occurred in 3 (4%) patients.There was no procedure-related mortality in our patients. Mild-to-moderate residual shunt was detectable in 10 (13.7%) patients immediately following the procedure and in 5 (6.7%) patients 24 hours after the procedure. None had residual flow across the device at the end of the follow-up period.
  
  
  CONCLUSIONS
  Device closure of ASD has a safety profile comparable to open surgical repair and can effectively close the defect with excellent procedural and mid-term results.
authors.affiliation: Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seifollah
authors.initials: S
authors.lastname: Abdi
authors.forename: Reza
authors.initials: R
authors.lastname: Kiani
authors.forename: Mahmood
authors.initials: M
authors.lastname: Momtahen
authors.forename: Hossein Ali
authors.initials: HA
authors.lastname: Basiri
authors.forename: Mohssen
authors.initials: M
authors.lastname: Maadani
authors.forename: Safarali
authors.initials: S
authors.lastname: Abdolrahimi
authors.forename: Iraj
authors.initials: I
authors.lastname: Firozi
authors.forename: HamidReza
authors.initials: H
authors.lastname: Sanati
authors.forename: Farshad
authors.initials: F
authors.lastname: Shakerian
authors.forename: Ata
authors.initials: A
authors.lastname: Firoozi
authors.forename: Negar
authors.initials: N
authors.lastname: Salehi
authors.forename: Ali
authors.initials: A
authors.lastname: Zahedmehr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D019919:Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D055815:Young Adult