title: Transcatheter closure of large atrial septal defects using 40 mm amplatzer septal occluder: Single group experience with short and intermediate term follow-up.
abstract: OBJECTIVE
  To assess feasibility, safety, and efficacy of the use of 40 mm Amplatzer septal occluder (ASO 40) for the closure of large atrial septal defects (ASD).
  
  
  BACKGROUND
  There is very little data available on closure of large ASDs with ASO 40.
  
  
  METHODS
  Case records of patients who underwent ASD closure with ASO 40 between 2002 and 2014 were retrospectively analyzed. All patients had clinical, transthoracic, and transesophageal echocardiographic (TEE) evaluation prior to device closure. Postclosure follow-up was done at 6 weeks, 6 months, and annually thereafter.
  
  
  RESULTS
  87 patients underwent ASD closure using ASO 40 during the study period. Mean age and weight of the group was 32.4 ± 11.6 years and 59.5 ± 11.3 kg respectively. Mean ASD diameter on TEE was 32 ± 2.8 mm. The balloon stretched diameter (N = 40) was 37.8 ± 1.3 mm. The balloon assisted technique was used in 80/87 patients for device deployment. The procedure was successful in 84/87 patients. Follow-up was available in 77 patients over a period of 44 ± 15.7 months. 3/77 patients had a small residual shunt. The severity of tricuspid regurgitation decreased in 40/77 patients. The pulmonary artery systolic pressure decreased from 49.7 ± 9.2 to 41.2 ± 6.2 mm Hg (N = 61; P < 0.05). The right ventricular diameter decreased from 35.1 ± 2.8 to 26.1 ± 3 mm (N = 77; P < 0.05).
  
  
  CONCLUSIONS
  ASO 40 can be used safely and effectively with promising short and intermediate term results.© 2016 Wiley Periodicals, Inc.
authors.affiliation: Glenmark Cardiac Centre, 101/102 Swami Krupa Coop Hsg Scty, D. L. Vaidya Road, Dadar (W), Mumbai, 400 028, India.
authors.forename: Bharat
authors.initials: B
authors.lastname: Dalvi
authors.affiliation: Department of Cardiology, Fortis Hospital, Mumbai, India.
authors.forename: Kshitij
authors.initials: K
authors.lastname: Sheth
authors.affiliation: Department of Cardiology, Sir HN Reliance Foundation Hospital, Mumbai, India.
authors.forename: Shreepal
authors.initials: S
authors.lastname: Jain
authors.affiliation: Glenmark Cardiac Centre, 101/102 Swami Krupa Coop Hsg Scty, D. L. Vaidya Road, Dadar (W), Mumbai, 400 028, India.
authors.forename: Robin
authors.initials: R
authors.lastname: Pinto
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008499:Medical Records; D011474:Prosthesis Design; D020127:Recovery of Function; D012189:Retrospective Studies; D055989:Septal Occluder Device; D013997:Time Factors; D016896:Treatment Outcome; D016278:Ventricular Function, Right; D055815:Young Adult
keywords: Device closure; congenital heart disease; shunt lesions