Transcatheter closure of secundum atrial septal defects with the Amplatzer occluder in adult patients.

BACKGROUND

Secundum atrial septal defect (ASD) is a common congenital heart disease diagnosed in adulthood. Data regarding the use of the percutaneous occluder device in adult populations are very limited and few studies including the use of the Amplatzer septal occluder (ASO) device in such populations are available. The aim of this study was to evaluAte the immediate and mid-term outcomes of the percutaneous ASD closure with the ASO device in an adult population.

METHODS

Between May 1999 and December 2000, 21 adult patients (8 males, 13 females) with a mean age of 44.6 +/- 15.1 years were enrolled for an attempt at ASD closure with the ASO device.

RESULTS

Only 18 of the 21 patients underwent implantation of the ASO device, whereas the other 3 patients were submitted to cardiac surgery. The ASO device was successfully implanted in 17 patients (94.4%). The mean maximal ASD transesophageal echocardiography diameter was 14.4 +/- 7.2 mm (range 4-23 mm). The mean stretched defect diameter measured 19.5 +/- 8.4 mm (range 8-34 mm) and the ASO implanted stalk size was 19.8 +/- 8.2 mm (range 8-34 mm). In 2 (11.1%) of the 18 patients a percutaneous transcatheter coronary angioplasty was successfully performed before implantation of the ASO device because of coronary artery disease. At 6 months of follow-up, transesophageal echo examination showed that the device was correctly positioned in all cases.

CONCLUSIONS

In adults, transcatheter closure of ASDs with the ASO device is a safe and effective alternative to surgical closure. The immediate and mid-term outcomes are excellent. However, a combined procedure may be necessary.