title: [Percutaneous transcatheter atrial septal defect closure with Amplatzer septal occluder device using three different techniques in three adult patients with complex ostium secundum type atrial defects].
abstract: Complex ostium secundum type atrial septal defect (ASD) is a definition used for large (stretched diameter over 26 mm with deficient rim) or multiple ASDs or multi-fenestrated septum or ASDs with redundant and aneurysmal septal rims. Compared to simple defects, transcatheter ASD closure with Amplatzer septal occluder (ASO) is relatively challenging in these cases, and different techniques have been defined to increase procedure success. We report three adult patients with complex ostium secundum type ASDs that were closed with ASO device using three different techniques. The first case was a 36-year-old female patient with complaints of dyspnea, palpitation and fatigue. A complex ostium secundum type ASD was diagnosed, and the defect was closed with a 36 mm ASO device using a left upper pulmonary vein technique. The second case was a 47-year-old female patient with complaints of dyspnea and palpitation. A large and complex ASD was detected, and the defect was closed with a 28 mm device using a left atrial roof technique supported by non-inflated balloon. The third case was a 40-year-old female patient who presented with complaints of dyspnea and palpitation. Complex ASD was diagnosed, and the defect was closed with a 32 mm device using a partially inflated balloon technique. In large and complex ASDs, the classical implantation technique of an ASO device may fail at any time. The knowledge and application of different techniques that orient the left atrial disc parallel to the septum may increase the procedure success and decrease complications.
authors.affiliation: Department of Cardiology, Kocaeli University Faculty of Medicine, Turkey. kilicteoman@yahoo.com
authors.forename: Teoman
authors.initials: T
authors.lastname: Kılıç
authors.forename: Tayfun
authors.initials: T
authors.lastname: Sahin
authors.forename: Ertan
authors.initials: E
authors.lastname: Ural
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D055989:Septal Occluder Device