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Large Amplatzer atrial septal occluder in growing children: an echographic study

Published online by Cambridge University Press:  13 May 2014

Marie-Josée Raboisson ,
Nicolas Hugues ,
Nagib Dahdah ,
Myriam Brassard ,
Chantale Lapierre  and
Joaquim Miró
Marie-Josée Raboisson*
Affiliation:
Department of Paediatrics, Division of Paediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
Nicolas Hugues
Affiliation:
Department of Paediatrics, Division of Paediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
Nagib Dahdah
Affiliation:
Department of Paediatrics, Division of Paediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
Myriam Brassard
Affiliation:
Department of Paediatrics, Division of Paediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
Chantale Lapierre
Affiliation:
Department of Paediatrics, Division of Paediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
Joaquim Miró
Affiliation:
Department of Paediatrics, Division of Paediatric Cardiology, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
*
Correspondence to: Dr M.-J. Raboisson, MD, Department of Padiatrics, Division of Cardiology, CHU Sainte Justine, 3175 Chemin de la Côte Sainte-Catherine, Montréal, QC, Canada H3T 1C5. Tel: +001 514 345 4931 ext 5410; Fax: +001 514 345 48 96; E-mail: [email protected]
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Abstract

Background: Lesions of adjacent structures have been reported after closure of large atrial septal defects with the Amplatzer septal occluder. In children, growth of the heart should modify the initial relationship between the device and surrounding structures. Aim: To compare the relationship between large Amplatzer septal occluder and adjacent cardiac structures at short-, mid-, and long-term follow-up in at-risk paediatric population using echocardiography. Methods: A total of 25 children (4.6±2.9 years old, 18 girls) with the largest atrial septal defect devices implanted between 1997 and 2002 were enrolled prospectively for complete echocardiogram 17.8±10.5 months (mid-term follow-up) and 8.8±0.9 years (long-term follow-up) after the procedure. Results were compared with the echocardiogram carried out 2.1±3.4 days after the procedure (short-term follow-up). Results: The minimal distance between the left disk and the mitral valve increased: 1.4±2.0 mm at short-term and 5.1±2.3 mm at long-term follow-up (p<0.05), leading to less contact between the disk and the anterior leaflet and less mitral regurgitation (10 at short-term, 4 at long-term follow-up, p<0.05). The number of devices straddling the aorta decreased from 17 to 12 at long-term follow-up (p<0.05). There was protrusion of disk in the venous structure in seven patients on the first echocardiogram, which disappeared at long-term follow-up. Conclusion: Although frequently in close contact with the aortic root, mitral valve, or venous returns, large devices tend to centre and move away from the surrounding structures, with decreased risk for long-term distortion.

Keywords

Amplatzer septal occluderaortic deformationatrial septal defect long-term follow-up
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 3 , March 2015 , pp. 468 - 475
Copyright
© Cambridge University Press 2014 

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References

1. Everett, AD, Jennings, J, Sibinga, E, et al. Community use of the Amplatzer atrial septal defect occluder: results of the multicenter MAGIC atrial septal defect study. Pediatr Cardiol 2009; 30: 240–247.Google Scholar
2. Sarris, GE, Kirvassilis, G, Zavaropoulos, P, et al. Surgery for complications of trans-catheter closure of atrial septal defects: a multi-institutional study from the European Congenital Heart Surgeons Association. Eur J Cardiothorac Surg 2010; 37: 1285–1290.Google Scholar
3. Butera, G, De Rosa, G, Chessa, M, et al. Transcatheter closure of atrial septal defect in young children: results and follow-up. J Am Coll Cardiol 2003; 42: 241–245.Google Scholar
4. Omeish, A, Hijazi, ZM. Transcatheter closure of atrial septal defects in children and adults using the Amplatzer septal occluder. J Interv Cardiol 2001; 14: 37–44.CrossRefGoogle ScholarPubMed
5. Diab, KA, Cao, QL, Bacha, EA, Hijazi, ZM. Device closure of atrial septal defects with the Amplatzer septal occluder: safety and outcome in infants. J Thorac Cardiovasc Surg 2007; 34: 960–966.Google Scholar
6. Delaney, JW, Li, JS, Rhodes, JF. Major complications associated with transcatheter atrial septal occluder implantation: a review of the medical literature and the manufacturer and user facility device experience (MAUDE) database. Congenit Heart Dis 2007; 4: 256–264.CrossRefGoogle Scholar
7. Amin, Z, Hijazi, ZM, Bass, JL, Cheatham, JP, Hellenbrand, WE, Kleinman, CS. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv 2004; 63: 496–502.Google Scholar
8. Divekar, A, Gaamangwe, T, Shaikh, N, Raabe, M, Ducas, J. Cardiac perforation after device closure of atrial septal defects with the Amplatzer septal occluder. J Am Coll Cardiol 2005; 45: 1213–1218.Google Scholar
9. Loeffelbein, F, Schlensak, C, Dittrich, S. Penetration of left and right atrial wall and aortic root by an Amplatzer atrial septal occluder in a nine year old boy with Marfan syndrome: Case report. J Cardiothorac Surg 2008; 6: 25.Google Scholar
10. Sauer, HH, Ntalakoura, K, Haun, C, Le, TP, Hraska, V. Early cardiac perforation after atrial septal defect closure with the Amplatzer septal occluder. Ann Thorac Surg 2006; 81: 2312–2313.Google Scholar
11. Preventza, O, Sampath-Kumar, S, Wasnick, J, Gold, JP. Late cardiac perforation following transcatheter atrial septal defect closure. Ann Thorac Surg 2004; 77: 1435–1437.Google Scholar
12. Wilson, WM, Goh, TH, Oqueli, E, et al. Aorto-left atrial fistula post-percutaneous device ASD closure. Heart Lung Circ 2010; 19: 53–55.Google Scholar
13. Li, W, Han, W, Yu, C, et al. Severe mitral valve insufficiency after transcatheter atrial septal defect closure with the Amplatzer septal occluder: a device-related complication. J Card Surg 2009; 24: 672–674.Google Scholar
14. Zoghbi, WA, Enriquez-Sarano, M, Foster, E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 2003; 16: 777–802.Google Scholar
15. Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495.Google Scholar
16. Smallhorn, JF, Pauperio, H, Benson, L, Freedom, RM, Rowe, RD. Pulsed Doppler assessment of pulmonary vein obstruction. Am Heart J 1985; 110: 483–486.Google Scholar
17. Kampmann, C, Wiethoff, C, Wenzel, A, et al. Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe. Heart 2000; 83 667–672.Google Scholar
18. Wilson, NJ, Smith, J, Prommete, B, O’Donnell, C, Gentles, TL, Ruygrok, PN. Transcatheter closure of secundum atrial septal defects with the Amplatzer septal occluder in adults and children-follow-up closure rates, degree of mitral regurgitation and evolution of arrhythmias. Heart Lung Circ 2008; 17: 318–324.Google Scholar
19. Huang, TC, Hsieh, KS, Lin, CC, Lee, CL. Clinical results of percutaneous closure of large secundum atrial septal defects in children using the Amplatzer septal occluder. Heart Vessels 2008; 23: 187–192.Google Scholar
20. Lapierre, C, Raboisson, MJ, Miró, J, Dahdah, N, Guérin, R. Evaluation of a large atrial septal occluder with cardiac MR imaging. RadioGraphics 2003; 23: S51–S58.CrossRefGoogle ScholarPubMed
21. Vogel, M, Berger, F, Dähnert, I, Ewert, P, Lange, PE. Treatment of atrial septal defects in symptomatic children aged less than 2 years of age using the Amplatzer septal occluder. Cardiol Young 2000; 10: 534–537.Google Scholar