title: Transcatheter closure of atrial septal defects in adolescents and adults: technique and difficulties.
abstract: OBJECTIVE
  to evaluate the results of transcatheter closure of atrial septal defect (ASD) in adolescents and adult.
  
  
  METHODS
  a case series of patients undergoing transcatheter closure of ASD in RS Cipto Mangunkusumo, Jakarta during 2002 -2013. Transesophageal echocardiography, hemodynamic study, and angiography were performed before the procedure. Oxygen test was done if PA pressure was more than 2/3 of aortic pressure, followed by an occlusion test if no response observed to determine whether the device could be released.
  
  
  RESULTS
  we enrolled 54 patients, of whom 26% were adolescents and 3% were males. Median body weight was 49 (26-75) kg and ASD size was 21 (9.4-39.6) mm. The procedure was done under general anesthesia in 26% of patients. Oxygen test was applied in 11% patients and occlusion test in 2% of patient. Transcatheter closure of ASD was successful in all patients using common technique (31%), right pulmonary vein-assisted (65%), left pulmonary assisted (2%), and cutting long sheath (2%). There was neither residual ASD nor complications observed. Mean fluoroscopy and procedure time were 29 (SD 18) and 109 (SD 36) minutes, respectively. Median hospital stay was 1 (1-3) day.
  
  
  CONCLUSIONS
  transcatheter closure of ASD in adolescents and adults is safe and effective.
authors.affiliation: Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta Indonesia.
authors.forename: Mulyadi M
authors.initials: MM
authors.lastname: Djer
authors.forename: Nuvi N
authors.initials: NN
authors.lastname: Ramadhina
authors.forename: Nikmah S
authors.initials: NS
authors.lastname: Idris
authors.forename: Dedi
authors.initials: D
authors.lastname: Wilson
authors.forename: Idrus
authors.initials: I
authors.lastname: Alwi
authors.forename: Muhammad
authors.initials: M
authors.lastname: Yamin
authors.forename: Ika P
authors.initials: IP
authors.lastname: Wijaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D062186:Arterial Pressure; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019919:Prosthesis Implantation / Q000379:methods*; D011651:Pulmonary Artery; D055989:Septal Occluder Device; D016896:Treatment Outcome; D055815:Young Adult