title: Transcatheter interatrial septal defect closure in a large cohort: midterm follow-up results.
abstract: OBJECTIVE
  We evaluated immediate and midterm results of transcatheter closure of atrial septal defects (ASDs) and patent foramen ovale (PFO) using various closure devices.
  
  
  METHODS
  The study included four hundred fourteen patients (one hundred eighty-two men, two hundred thirty-two women; mean age 39 ± 12.3 years; range 17-67 years) who underwent transcatheter closure of secundum ASD (n = 193) or PFO (n = 221). All the patients were evaluated by transthoracic echocardiography and transesophageal echocardiography before the procedure. Transcatheter closure was performed by using Amplatzer (n = 184), Occlutech Figulla (n = 209), or BioSTAR (n = 21) devices. Closure of ASDs was performed under general anesthesia with transesophageal echocardiography guidance, and closure of PFOs was performed under local anesthesia with transthoracic echocardiography guidance. Follow-up controls were at 1, 6, and 12 months and annually thereafter. The median follow-up periods of ASD and PFO patients were 43 and 30 months.
  
  
  RESULTS
  The mean device size was 19.3 ± 6.2 mm for ASD patients and 24.6 ± 2.6 mm for PFO patients. The mean procedural and fluoroscopy times were 22.3 ± 4.7 and 4.1 ± 1.9 minutes for ASD closure and 12.4 ± 3.2 and 3.1 ± 1.2 minutes for PFO closure, respectively. Procedural device embolization occurred in only two patients (0.48%). During follow-up, recurrent embolic events occurred in four patients (1.8%) after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two ASD patients during the procedure and in one PFO patient at 12th month of the follow-up (0.72%).
  
  
  CONCLUSIONS
  Transcatheter closure of PFOs and secundum-type ASDs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an efficacious and safe therapeutic option.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Süheyla
authors.initials: S
authors.lastname: Özkutlu
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Ergün Barış
authors.initials: EB
authors.lastname: Kaya
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Levent
authors.initials: L
authors.lastname: Şahiner
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Ateş
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakçı
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D015331:Cohort Studies; D004452:Echocardiography; D004617:Embolism / Q000209:etiology*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D055989:Septal Occluder Device / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Atrial Septal Defect; Occluder Device; Patent Foramen Ovale