Transcatheter closure of atrial septal defects with multiple devices in adults: Procedural and clinical outcomes

Vaikom S. Mahadevan, Natalie Gomperts, Kim Haberer, Candice Silversides, Lee N. Benson, Peter R. McLaughlin, Eric M. Horlick

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objective: This study reports the procedural, short and medium term outcomes in patients receiving multiple implants for device closure of secundum atrial septal defects (ASD). Design and setting: From the database of the Toronto Congenital Cardiac Centre, 36 consecutive patients (mean age 46 ± 15 years; 23 females) received > 1 implant for closure of an interatrial communication. Short term (mean 97 ± 77 days) and medium term (mean 2.5 ± 1.4 years) follow-up data were analyzed. Procedures were performed under intracardiac echo (ICE) and fluoroscopic guidance. Results: The Amplatzer Septal Occluder (ASO™) was implanted in all except one. Thirty-one patients had 2, and 4 patients, 3 ASO™ devices. There were no major adverse events at implantation or on follow-up. Patients with > NYHA class I symptoms fell from 44% to 6% (p < 0.05) at 3 months. Right ventricular (RV) systolic pressure fell from 39 ± 7 to 32 ± 4 mm Hg in the short term (p < 0.05), and to 30 ± 4 mm Hg in the medium term (p < 0.05, compared to baseline) and RV diameters fell from 48 ± 5 to 40 ± 5 (p < 0.05) in the short term and to 38 ± 8 mm (p = ns) in the medium term. Small residual leaks were present in 22% at 3 months and 12% (p < 0.05) at 1 year. Conclusion: Multiple ASD device implants can be safely employed with excellent outcomes. Significant reductions in RV pressure and diameter occur in the short term with a continued trend to benefit.

Original languageEnglish (US)
Pages (from-to)359-363
Number of pages5
JournalInternational Journal of Cardiology
Volume133
Issue number3
DOIs
StatePublished - Apr 17 2009
Externally publishedYes

Keywords

  • Atrial septal defect
  • Congenital heart disease
  • Multiple defects
  • Multiple devices

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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