Resolution of right heart enlargement after closure of secundum atrial septal defect with transcatheter technique11IRB approval and informed consent were both obtained for placement of the Amplatzer Septal Occluder device.
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Septum secundum
Volume overload
Heart septal defect
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Objective: To evaluate the feasibility and utility of transcatheter closure of secundum atrial septal defect using Amplatzer occluder under transthoracic echocardiography(TTE) guidance. Methods: 18 patients with secundum atrial septal defect (ASD) were diagnosed. The Amplatzer occluder was used for transcatheter closure of secundum atrial septal defect under TTE and X-ray guidance for all the patients. Results: The Amplatzer occluder was deployed correctly in all patients except two patients who underwent cardiac operation. There were complete closures in 16 patients immediately. 16 patients were followed up from 3 months to 2 years after operation, the closure of ASD was still complete in all patients.no residual shunt or any other complications occurred. Conclusions: Amplatzer occluder is an efficient and safe nonsurgical method for closure of secundum atrial septal defect under TTE and X-ray guidance.
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Transcatheter closure of secundum atrial septal defects (ASD) in patients with levocardia is performed routinely using various investigational devices. A 6-yr-old child with dextrocardia, situs inversus, and secundum ASD measuring 13 mm by TEE underwent successful transcatheter closure using a 15 mm Amplatzer Septal Occluder with complete closure of the defect. Cathet. Cardiovasc. Diagn. 43:291–294, 1998. © 1998 Wiley-Liss, Inc.
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Abstract The aim of the study was to assess the morphology of secundum‐type atrial septal defects (ASD) with a view to percutaneous closure using Amplatzer septal occluders (ASO). One hundred and ninety patients who underwent closure of isolated secundum‐type ASD between September 1995 and January 2000 were included. The morphology of the defects was studied using transthoracic and transesophageal echocardiography. Patients with defects of suitable morphology and size underwent percutaneous closure using ASO. The remaining patients underwent surgical closure. Centrally placed defects were observed in 46 patients (24.2%). Morphological variations of secundum‐type ASD were detected in 144 patients (75.8%). One hundred and fifty‐one patients (79.5%) underwent percutaneous closure using ASO. Thirty‐nine patients (20.5%) underwent surgical closure. Centrally placed defects, defects with deficient superior anterior rim, multiple defects, and perforated aneurysms of the interatrial septum are morphological variations of secundum‐type ASD suitable for percutaneous closure using ASO. Cathet Cardiovasc Intervent 2001;53:386–391. © 2001 Wiley‐Liss, Inc.
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Atrial septal defect (ASD) is a common congenital heart disease in adults. Amplatzer septal occluder is one of the most common devices used for transcatheter closure due to its high success rate and ease to implant. Cocoon atrial septal occluder is a new nitinol-based device, its shape resembles Amplatzer septal occluder but coated with platinum to prevent nickel release. Little is known about clinical outcomes of large ASD closure using Cocoon atrial septal occluderTo review our experience in closure of secundum ASD in adults by Cocoon septal occluder and to compare the clinical outcomes and results of the patients who had ASD closure with a device greater than or equal to 30 mm and less than 30 mm.Between November 2005 and October 2008, 63 consecutive patients underwent transesophageal echocardiography (TEE)--guided transcatheter closure of secundum ASD. The patients were divided into two groups (Groups' 1 and 2) according to device diameter that is greater than or equal to 30 mm (n = 31) and less than 30 mm (n = 32), respectively. Clinical outcomes, complications, and transthoracic echocardiography (TTE) before hospital discharge, one to three months, and one-year were analyzed.Device implantations were successful in 27 patients (87.1%) in group 1 and 31 patients (96.9%) in group 2 (p = 0.196). The maximum size of secundum ASD in group 1 determined by TTE, TEE, and balloon sizing diameter (BSD) were 22.6 +/- 5.0 mm (range 15-32), 28.1 +/- 4.8 mm (range 19-39), and 31 +/- 3.5 mm (range 23-38) respectively. The maximum size of secundum ASD in group 2 determined by TTE, TEE, and BSD were 19.7 +/- 4.4 mm (range 12-31), 20.4 +/- 3.4 mm (range 13-26), and 23.1 +/- 2.9 mm (range 15-30) respectively. The mean device size in groups 1 and 2 were 33.5 +/- 3.1 mm and 24.6 +/- 3.3 mm, respectively. Four patients (12.9%) in group 1 had unsuccessful implantations. All of them were in the first 15 cases of using large device and two of them had device embolization requiring surgical removal. One patient (3.1%) in group 2 had an unsuccessful implantation and had device embolization requiring surgical removal. The patients in both groups gradually improved in clinical symptoms with decreased RVsystolic pressure and decreased RV size with complete ASD closure at one yearTranscatheter closure of large secundum ASD by Cocoon septal occluder is feasible with hemodynamic benefit. However complication rates are higher with large ASD closure with device size greater than or equal to 30 mm especially during the early "learning curve" period. With experience, the complication rate declines and the success rate is no different from the group with smaller device size.
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A 4-year-old, late-term pregnant Himalayan queen was diagnosed with biventricular congestive heart failure characterized by pleural effusion and pulmonary edema. A cesarean section was performed, resulting in the birth of four live kittens, with one surviving to discharge. Congestive heart failure resolved rapidly following surgery. The queen remained asymptomatic for 9 years postoperatively. Volume expansion secondary to pregnancy was thought to result in cardiovascular volume overload and subsequent congestive heart failure.
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Objective To estimate the feasibility and efficacy of real time three dimensional echocardiography(RT 3DE) in closure of secundum atrial septal defect(ASD) using Amplatzer septal occluder(ASO) in children.Methods Ten children patients with ASD and 9 children patients post closure using Amplatzer septal occluder were examined by transthoracic RT 3DE (Live 3D mode and Full Volume mode).Results The three dimensional view of ASD and ASO was displayed clearly by RT 3DE,including size,shape,position and spatial relations of ASD and ASO.Conclusions ASD and ASO could be evaluated quickly and accurately by RT 3DE,which has great value in closure of ASD.
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