Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct
We report our clinical experience with the newly developed Amplatzer device in transcatheter closure of nine atrial septal defects (ASDs), one ventricular septal defect (VSD), and one patent arterial duct (PDA). Eleven patients with ASD (age range 2.5-18 years) selected according to the locat...
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| Format: | Article |
| Language: | English |
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Hacettepe University Institute of Child Health
2001-01-01
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| Series: | The Turkish Journal of Pediatrics |
| Online Access: | https://turkjpediatr.org/article/view/3009 |
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| author | A Bilgiç A Celiker S Ozkutlu C Ayabakan T Karagöz T Ocal |
| author_facet | A Bilgiç A Celiker S Ozkutlu C Ayabakan T Karagöz T Ocal |
| author_sort | A Bilgiç |
| collection | DOAJ |
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We report our clinical experience with the newly developed Amplatzer device in transcatheter closure of nine atrial septal defects (ASDs), one ventricular septal defect (VSD), and one patent arterial duct (PDA). Eleven patients with ASD (age range 2.5-18 years) selected according to the location and size of the defect by transesophageal echocardiography (TEE), a five-year-old patient with muscular VSD and a one-year-old patient with PDA were considered for transcatheter closure with Amplatzer devices. All procedures were performed under general anesthesia with fluoroscopic and TEE guidance, following a routine hemodynamic evaluation in the catheter laboratory. The optimal device size was selected after the balloon sizing of the ASDs. The sizes of the VSD and PDA were measured on TEE and angiography. The patients were discharged at 24 hours, after an evaluation with x-ray, electrocardiogram (ECG), and echocardiography; they were on 3-5 mg/kg/day aspirin and infective endocarditis prophylaxis for six months after the procedure. They were reassessed at six to eight weeks and Holter monitoring was done in addition. Devices were used for nine ASD patients, and for the VSD and the PDA patients. Mean ASD size was 14.3 +/- 5.3 mm at TEE and 18.3 +/- 4.3 mm at balloon sizing (p=0.02). The mean size of the device was 18.7 +/- 4.2 mm. The procedure time and the fluoroscopy time were 46.1 +/- 12.3 and 12.9 +/- 1.6 minutes, respectively. Immediately after the procedure, four patients (44%) had trivial shunts (TS). TS remained in only two during discharge, and no shunt was observed at second evaluation. The devices were similarly applied to VSD (12-7 mm) and PDA (8-6 mm) patients. Both cases had TS immediately, which disappeared at 24 hours. None of the patients had major complications. Junctional rhythm developed in one patient, and another patient had frequent supraventricular extrasystoles. Amplatzer is an effective and safe device for transcatheter closure of ASD, VSD, or PDA, especially in pediatric patients.
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| format | Article |
| id | doaj-art-b6bd4b5d96be45269289967b91eabef4 |
| institution | DOAJ |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2001-01-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-b6bd4b5d96be45269289967b91eabef42025-08-20T02:58:14ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212001-01-01431Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial ductA Bilgiç0A CelikerS OzkutluC AyabakanT KaragözT OcalDepartment of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey. We report our clinical experience with the newly developed Amplatzer device in transcatheter closure of nine atrial septal defects (ASDs), one ventricular septal defect (VSD), and one patent arterial duct (PDA). Eleven patients with ASD (age range 2.5-18 years) selected according to the location and size of the defect by transesophageal echocardiography (TEE), a five-year-old patient with muscular VSD and a one-year-old patient with PDA were considered for transcatheter closure with Amplatzer devices. All procedures were performed under general anesthesia with fluoroscopic and TEE guidance, following a routine hemodynamic evaluation in the catheter laboratory. The optimal device size was selected after the balloon sizing of the ASDs. The sizes of the VSD and PDA were measured on TEE and angiography. The patients were discharged at 24 hours, after an evaluation with x-ray, electrocardiogram (ECG), and echocardiography; they were on 3-5 mg/kg/day aspirin and infective endocarditis prophylaxis for six months after the procedure. They were reassessed at six to eight weeks and Holter monitoring was done in addition. Devices were used for nine ASD patients, and for the VSD and the PDA patients. Mean ASD size was 14.3 +/- 5.3 mm at TEE and 18.3 +/- 4.3 mm at balloon sizing (p=0.02). The mean size of the device was 18.7 +/- 4.2 mm. The procedure time and the fluoroscopy time were 46.1 +/- 12.3 and 12.9 +/- 1.6 minutes, respectively. Immediately after the procedure, four patients (44%) had trivial shunts (TS). TS remained in only two during discharge, and no shunt was observed at second evaluation. The devices were similarly applied to VSD (12-7 mm) and PDA (8-6 mm) patients. Both cases had TS immediately, which disappeared at 24 hours. None of the patients had major complications. Junctional rhythm developed in one patient, and another patient had frequent supraventricular extrasystoles. Amplatzer is an effective and safe device for transcatheter closure of ASD, VSD, or PDA, especially in pediatric patients. https://turkjpediatr.org/article/view/3009 |
| spellingShingle | A Bilgiç A Celiker S Ozkutlu C Ayabakan T Karagöz T Ocal Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct The Turkish Journal of Pediatrics |
| title | Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct |
| title_full | Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct |
| title_fullStr | Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct |
| title_full_unstemmed | Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct |
| title_short | Transcatheter closure of secundum atrial septal defects, a ventricular septal defect, and a patent arterial duct |
| title_sort | transcatheter closure of secundum atrial septal defects a ventricular septal defect and a patent arterial duct |
| url | https://turkjpediatr.org/article/view/3009 |
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