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Transcatheter closure of atrial septal defects within the oval fossa: medium-term results in children using the ‘ASDOS’-technique

Published online by Cambridge University Press:  19 August 2008

Gerd Hausdorf ,
Martin Schneider ,
Christoph Fink ,
Ulrich Neudorf ,
Gunther Fischer ,
Michael Tynan  and
Beat Friedli
Gerd Hausdorf*
Affiliation:
Departments of Pediatric Cardiology of the Medizinische Hochschule Hannover (Germany)
Martin Schneider
Affiliation:
Departments of Pediatric Cardiology of the Charité-Berlin (Germany)
Christoph Fink
Affiliation:
Departments of Pediatric Cardiology of the Charité-Berlin (Germany)
Ulrich Neudorf
Affiliation:
Departments of Pediatric Cardiology of the Universitätsklinik Essen (Germany)
Gunther Fischer
Affiliation:
Departments of Pediatric Cardiology of the Christian Albrechts Universität Kiel (Germany)
Michael Tynan
Affiliation:
Departments of Pediatric Cardiology of the Guy’s Hospital London (UK)
Beat Friedli
Affiliation:
Departments of Pediatric Cardiology of the University Hospital Geneva (Switzerland)
*
Prof.Dr.Gerd Hausdorf, Medizinische Hochschule Hannover, Department of Pediatrics III and Pediatric Cardiology, Carl-Neuberg Str.l, D-30625 Hannover, Germany. Fax: 511-532-9038
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Abstract

Objectives

The purpose of this study was to evaluate the safety and efficacy of the ASDOS-tech-nique (Sulzer-Osypka GmbH, Germany) for transcatheter closure of atrial septal defects within the oval fossa.

Background

Although several attempts have been made to occlude defects within the oval fossa by transcatheter techniques, none of these has gained general acceptance.

Methods

Patients with a defect in the oval fossa measuring equal to or less than 20 mm diameter, with a residual septal rim of 5mm or greater, body weight greater than 10 kg, with clinical indications for surgical closure were considered for transcatheter closure. Follow-up investigations were performed at discharge, after 1, 3, 6 and 9 months, as well as after 1 and 2 years.

Results

Of 78 patients considered for closure, a device was inserted in 41 patients (53%), with success being achieved in 40 patients (98%). The ages ranged from 1.1 to 15 years (7.8 ± 1.92 years), the ’stretched’ diameter of the defect from 10 to 20 mm (14.7 ± 2.60 mm), and the diameters of the inserted devices from 25 to 45 mm (33.2 ± 5.43 mm). Transient impairment of atrioventricular conduction occured in 4 patients. During the follow-up of 23.0 ± 5.6 months elective surgical closure of a residual shunt was performed 26 months after insertion of the devcie in one patient. None of the other patients required surgery, hospitalisation or medical treatment, and none is requiring further treatment of the defect within the oval fossa. Fracture of one arm of the device occurred in 4 patients, but the fractured arms are in an unchanged and stable position after a period of at least 19 months.

Conclusions

Our medium-term data show that transcatheter closure in children of defects within the oval fossa can be performed with a high efficacy and safety using the ASDOS-device.

Keywords

Atrial septal defectinterventional cardiologyclosure devicesbiomaterials
Type
Original Articles
Information
Cardiology in the Young , Volume 8 , Issue 4 , October 1998 , pp. 462 - 471
Copyright
Copyright © Cambridge University Press 1998

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