Postoperative Outcome of the Transcatheter Closure of Atrial Septal Defects Using the AMPLATZER Septal Occluder

Abstract

Background: The AMPLATZER Septal Occluder (ASO) has successfully replaced surgery for the repair of atrial septal defects (ASDs) within the last decade. However, the outcome and clinical consequences of this procedure have not been fully assessed. Hence, the present study aimed to determine the results of the application of the ASO in the nonsurgical transcatheter closure of ASDs. Methods: Forty-seven consecutive patients were assessed via transesophageal echocardiography to determine secundum ASDs. The study end points were the assessment of the echocardiographic consequences of ASD closure using the ASO and also the determination of the presence of postoperative complications. The patients were reassessed via transthoracic echocardiography 1 day, 1 month, and also 6 months after the intervention. Results: An assessment of the trend of the changes in right ventricular dimension and functional status showed a significant decrease in right ventricular size as well as improvement in function within 6 months after ASD closure using the ASO. The mean pulmonary artery pressure was also significantly decreased. Unsuccessful ASD closure was detected in only 3 patients, with an overall failure rate of 6.4%. Regarding postoperative complications, device displacement was found in 2.1%, interatrial septum rupture in 12.8%, small pericardial effusion in 12.8%, tamponade in 2.1%, and small residual ASDs in 12.8%, all of which were resolved procedurally within the following month. Conclusions: The clinical efficacy of the nonsurgical transcatheter closure of ASDs with the ASO was underlined in our experiment, indicating that it is a good and standard alternative to surgical repair. (Iranian Heart Journal 2017; 17(4): 30-35)