HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
[Advanced]

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this link to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Add article to my folders
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rickers, C
Right arrow Articles by Weil, J
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rickers, C
Right arrow Articles by Weil, J

Heart 1998;80:517-521 ( November )

Percutaneous closure of secundum atrial septal defect with a new self centring device ("angel wings")

C Rickers,a C Hamm,b H Stern,a T Hofmann,b O Franzen,b R Schräder,c H Sievert,c D Schranz,d I Michel-Behnke,d J Vogt,e D Kececioglu,e W Sebening,f A Eicken,f H Meyer,g W Matthies,g F Kleber,h J Hug,h J Weila

a Department of Paediatric Cardiology, University Hospital Eppendorf, Hamburg, Germany, b Department of Cardiology, University Hospital Eppendorf, c Department of Cardiology, Hospital Bethanien, Frankfurt, Germany, d Department of Paediatric Cardiology, University Hospital Giebeta en, Germany, e Department of Paediatric Cardiology, University Hospital, Münster, Germany, f Department of Paediatric Cardiology, Heart Center Munich, Germany, g Department of Cardiology, Heart Center Bad Oeynhausen, Germany, h Department of Cardiology, Charité Campus Virchow Klinikum, Humboldt University of Berlin and German Heart Institute Berlin, Germany

Correspondence to: Dr C Rickers, University Hospital Eppendorf, Department of Paediatric Cardiology, Martinistrasse 52 20246 Hamburg, Germany.

Accepted for publication 24 June 1998

Objective---To investigate the safety, efficacy, and clinical application of a new self centring device ("angel wings") for closure of secundum atrial septal defects (ASD II) and persistent foramen ovale in all age groups.
Design---Multicentre, prospective, non-randomised study.
Patients---Inclusion criteria: defects with an occlusive diameter of =< 20 mm and a surrounding rim of > 4 mm; body weight > 10 kg; and an indication for surgical closure of secundum atrial septal defect. Additionally, there were compassionate indications for closure in patients with persistent foramen ovale.
Interventions---Defects were closed by a transcatheter device consisting of two square frames made of superelastic nitinol wire. The frames are covered by elastic polyester fabric, which is sewn together at a central circle. All procedures, except for three interventions that were carried out under sedation, were performed under general anaesthesia using transoesophageal echocardiography and fluoroscopy to monitor intervention.
Results---Closure was attempted in 75 (71%) of 105 patients. An ASD II was present in 35 children and 15 adults. A persistent foramen ovale was present in 25 adults with suspected paradoxical embolism. Transcatheter closure was unsuccessful in three children and crossover to surgery was required. Residual shunts were found in 20 patients (27%) immediately after the procedure. A transient atrioventricular third degree block occurred in three patients (4%) and the right atrial disk was not fully deployed in three. A minor shunt (< 3 mm) was present in only three (4%) of 72 patients during follow up of 1-17 months. Blood clots on the right atrial disks in two patients (one required lysis) were seen during follow up transoesophageal echocardiography. Serious complications demanding surgical removal of the device occurred in three patients. One patient had haemopericardial tamponade because of an aortic lesion. Left atrial thrombus formation due to an unfolded right atrial disk was found in a second patient and dislodgement of the left atrial disk resulted in a large residual shunt in a third.
Conclusions---Percutaneous closure of a central ASD with a diameter =< 20 mm in paediatric and adult patients is feasible and effective with this new device. It is a promising alternative to surgical closure. Modifications of the design, however, seem to be mandatory as 4% of patients developed serious complications.

Keywords: secundum atrial septal defect;  persistent foramen ovale;  interventional cardiology;  transcatheter occlusion


© 1998 by Heart



This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
K. Suda, M.-J. Raboisson, E. Piette, N. S. Dahdah, and J. Miro
Reversible atrioventricular block associated with closure of atrial septal defects using the amplatzer device
J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1677 - 1682.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
R. K. Deeik, R. M. Thomas, P. Sakiyalak, S. Botkin, B. Blakeman, and M. Bakhos
Minimal access closure of patent foramen ovale: is it also recommended for patients with paradoxical emboli?
Ann. Thorac. Surg., October 1, 2002; 74(4): S1326 - 1329.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. U. Braun, D. Fassbender, S. P. Schoen, M. Haass, R. Schraeder, W. Scholtz, and R. H. Strasser
Transcatheter closure of patent foramen ovale in patients with cerebral ischemia
J. Am. Coll. Cardiol., June 19, 2002; 39(12): 2019 - 2025.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
M L Rigby
Transoesophageal echocardiography during interventional cardiac catheterisation in congenital heart disease
Heart, December 1, 2001; 86(90002): ii23 - 29.
[Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
P. A. Berdat, T. Chatterjee, J.-P. Pfammatter, S. Windecker, B. Meier, and T. Carrel
Surgical management of complications after transcatheter closure of an atrial septal defect or patent foramen ovale
J. Thorac. Cardiovasc. Surg., December 1, 2000; 120(6): 1034 - 1039.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
M. E. Brickner, L. D. Hillis, and R. A. Lange
Congenital Heart Disease in Adults- First of Two Parts
N. Engl. J. Med., January 27, 2000; 342(4): 256 - 263.
[Full Text] [PDF]


Home page
HeartHome page
M. L RIGBY
The era of transcatheter closure of atrial septal defects
Heart, March 1, 1999; 81(3): 227 - 228.
[Full Text]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
Terms and conditions relating to subscriptions purchased online  ¦  Website terms and conditions  ¦  Privacy policy
Copyright © 1998 BMJ Publishing Group Ltd & British Cardiovascular Society