Background: We reviewed our experience using the Amplatzer septal occluder (AGA Medical, Golden Valley, MN) to close large, secundum-type atrial septal defects (ASDs) in children.
Methods: Between June 2002 and December 2005, 52 patients (mean age 13.5 ¡Ó 8.7 years) underwent transcatheter closure of large (≥25 mm), secundum ASDs by using the Amplatzer septal occluder (ASO). Groups 1 and 2 included patients with a retroaortic rim of <5 mm (n = 39) or ≥5 mm(n = 13), respectively. All procedures were performed with general anesthesia and transesophageal echocardiographic guidance except for 10 patients, which involved local anesthesia and 3-dimensional transthoracic echocardiography. Successful device implantations, device sizes, approaches, complications, and closure rates were assessed.
Results: Device implantation was successful in 50 patients (96.1%), with no difference between groups (95% vs 100%, P > 0.05). In 2 patients, implantation failed because of embolism or deployment failure. Devices were larger in group 1 than in group 2 (29.7 ¡Ó 3.9 vs 26.7 ¡Ó 3.0 mm, P =0.04). The right upper pulmonary-vein approach was more common in group
1 than in group 2 (P = .0001). Complications and closure rates did not differ between the groups (P > .05).
Conclusions: Transcatheter closure of large, secundum ASD by using the ASO device was feasible, and complication rates were low. A deficient retroaortic rim did not preclude successful device implantation; however, a large device may be needed to close large ASD. Close long-term follow-up is necessary to determine the safety of transcatheter closure of large ASDs in children.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0618107-123104 |
| Date | 18 June 2007 |
| Creators | Huang, Ta-Cheng |
| Contributors | Ger Luo-Ping, Lee Cheng-Liang, Pai Hsiu-Hua, Shiue Yow Ling |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | Cholon |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0618107-123104 |
| Rights | restricted, Copyright information available at source archive |
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