Transcatheter study closure of atrial septal defect using the amplatzer septal occluder in Jordanian children

الملخص EN

Several devices are available for the transcatheter occlusion of an atrial septal defect (ASD).

This report describes our initial clinical experience at the Queen Alia Heart Institute in Jordan with a new self-centering device “The Amplatzer septal occluder" (ASO).

During 1997 twenty two transcatheter atrial septal defect occlusions were performed with the ASO in children aged between 2 and 13.3 years (median 5.1 years) and with stretched atrial defects measuring between X and 24mm in diameter (median 16mm).

Transesophageal echocardiography (TEE) was done on all the patients, all of whom had right atrial and right ventricular volume overloads with median Qp/Qs 1.65:1.

The defects were closed with 12 to 26 mm devices delivered through 7Fr.

sheaths.There was immediate and complete closure of ASD in 20 of the 22 patients (91%); one patient had trivial mitral regurgitation and another had supraventricular tachycardia (SVT) during implantation.

One patient developed a transient neurological deficit (right-sided weakness) which recovered completely after three days.

Follow-up was performed using transthoracic echocardiography (TTE) at one day and at three months.

At one day there was complete closure of ASD in 20/22 patients (91%), at three months residual shunting was observed in one patient making the closure rate 95%.

There have been no episodes of endocarditis, wire fracture, disruption of the device, episodes of device embolization or further thrombo-embolism.

Despite our limited experience the results indicate that transcatlieter occlusion of ASD is feasible, relatively safe, effective and this new device seems to be promising for the closure of ASD in children.

However, further long-term clinical trials are needed before this device can be generally recommended.