Transcatheter Occlusion of Secundum Atrial Septal Defects with Latest Generation Coated Nitinol Wire Devices

ABSTRACT Background Transcatheter occlusion of ostium secundum atrial septal defects using commercial available devices is a safe and effective procedure. We present our experience with two new generation coated nitinol wire devices. Methods We report device characteristics, implantation technique and outcomes of patients with atrial septal defects treated with the Lifetech CERA™ ASD Occluder and the Cocoon Septal Occluder. Results Procedures were performed in 49 patients, 37 were female. Ages ranged from 7 to 68 years and body weight from 17 to 90 kg. The aortic rim was present in 34.7% and atrial septal aneurysms in 14.3% of the patients. Mean diameter was 13 ± 7 mm whereas the balloon stretched diameter was 22 ± 7 mm. Implantation was possible in all cases and 55 devices were used. Forty-five CERA™ and four Cocoon devices were used. Three patients required occlusion of a second orifice. During the procedures the first device had to be replaced by a larger one in two cases, and in the third case it was replaced due to a tuliplike malformation of the left atrial disc. Immediate occlusion occurred in 91.9% and in 95.9% at 6 months. There were no deaths or other significant complications. Conclusions The use of both CERA™ and Cocoon devices was simple and reproducible in experienced hands. Short-term occlusion rates were similar to the ones obtained with the Amplatzer™ device. More studies and long-term follow-up are required to determine the actual advantages of coated nitinol wire devices.