Transcatheter closure of secundum atrial defects with "antplatzer septal occluder" initial experience in Jordan

Abstract EN

Objective : To evaluate the efficacy and safety of a new self centering device, the Amplatzer Septal Occluder (ASO) in closing secundum Ah·ial septal defects (ASD's) and to present our initial experience in Jordan.

Design: Cohort sample of consecutive 16 patients with ASD's selected to fulfill the c1·iteria of measuring ::: ;2.2 em with enough tissue rim > 5 mrn sunounding the defect.

Setting: The cath lab of Queen Alia Heart Institute, Amman, Jordan.

Subjects: Sixteen patients (1 2 males, 4 females) with secundum A SO's, aged 2 - 37.1 yeat·s (median 5.25 years) with median weight of patients of 16.5 Kg (range 10-68 Kg).

J\llain outcome and measures: {1) Immediate success post delivery of the device as measured by the immediate degree of shunting assessed by pulmonary artery angiogram wi.th levophase and Transoesophageal echocardiog•·aphy.

(2) Degt·cc of shunting I day, 3 months after delivet·y of the device as measured by Transoesophageal echocardiography.

(3) ReconJing an) medical complications or any death upon clinical follow-up to the p::ttients till 3 months post device delivery.

Results: There was immediate and complete (C) closure of ASD in 14/16 patients.

One patient had triviHl residual shunt (TS) and another one had small residual shunt (SS).

There was no episode of device embolization or any need for blood h·ansfusion.

One patient developed transient neurologic deficit (right sided weakness) with near complete clinical recovery aftea· few days .

• Follow-up by Transoesophageal echocardiog•·aphy (TEE) at 3 months showed residual shunting was not observed in any one of our patients.

There was no incidence of endocarditis, wire fracture or further thromboembolism.

Interpretation and Conclusions: The ASO seems to be a promising device for the closure of ASD in children and adults.

Further evaluation and long term data see1n to be necessary before tllis new technique can be recommended.