Immediate, Short and Intermediate Results of Transcatheter Closure of Secondum-Type Atrial Septal Defect Using Amplatzer Septal Occluder Devices
Kriengkrai Hengrussamee MD*, Peerapat Katekangplu MD*, Pornwalee Porapakkham MD*, Vathanyoo Plainetr MD*, Anek Kanoksin MD*, Jarin Assavahanrit MD*, Boonjong Saejueng MD*
Affiliation : * Department of Cardiology, Chest Disease Institute, Nonthaburi
Objectives: To study the immediate, short, and intermediate results of transcatheter closure of secondum-type
atrial septal defect using Amplatzer septal occluder devices (TCAA) in terms of clinical symptoms and residual
lesions and shunts determined by transthoracic two-dimensional (TTE) and three-dimensional
echocardiography (TDE).
Material and Method: Thirty-six patients, who underwent successful TCAA at the Chest Disease Institute
between August 2002 and August 2007 and were followed up clinically, by TTE and TDE at day 1-3, 4-6
months, and 1-year post TCAA, were analyzed.
Results : TCAA was performed in 75 patients during the study period. Of these, 36 patients were completely
followed-up. There were 92% female with a mean age of 40 + 16 yrs (range19 to 65) and the mean of maximal
size of ASD secondum determined by TTE, transesophageal echocardiography (TTE) and balloon sizing or
balloon stretched diameter (BSD)was 18.9 + 4.7 mm (range10-30), 22.6 + 5.3 mm (rang10-32), and 24.3 +
5.3 mm (range12-34 ) respectively. The size of ASOD was 26.4 + 4.9 mm (range12-34).Fluoroscopic time was
16.4 + 7.1 min (range 6.7-35.6). The success rate of TCAA was 84%. No major complications and deaths were
found. All of those with successful TCAA apparently improved their functional class. All of them showed
complete ASD closure and yet 12 (31%) had Qp/Qs > 1.5 at year one.
Conclusion : TCAA is safe and effective and had resulted in clinical improvement, complete closure of secondum
ASD, and good immediate, short, and intermediate outcomes with fewer complications.
Keywords : Secondum-type atrial septal defect (ASDII), Amplatzer septal occluder device (ASOD), Transthoracic echocardiography (TTE), Transesophageal echocardiography (TEE), Three dimensional echocardiography (TDE)
