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Predictors of residual defects following closure of defects in the oval fossa using the Amplatzer device: echocardiography recapitulates morphometry

Published online by Cambridge University Press:  24 May 2005

Duraisamy Balaguru ,
Robert H. Anderson ,
Geoffrey L. Rosenthal ,
Andrew C. Cook ,
Wolfgang A.K. Radtke  and
Girish S. Shirali
Duraisamy Balaguru
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, USA
Robert H. Anderson
Affiliation:
Institute of Child Health, University College, London, United Kingdom
Geoffrey L. Rosenthal
Affiliation:
Cleveland Clinic Foundation, Cleveland, Ohio, USA
Andrew C. Cook
Affiliation:
Institute of Child Health, University College, London, United Kingdom
Wolfgang A.K. Radtke
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, USA
Girish S. Shirali
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, USA
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Abstract

Objectives: This study was designed to identify predictors of residual defects following deployment of the Amplatzer device to close septal defects within the oval fossa. Methods: Between February 1997 and February 2000, we used the Amplatzer device to close defects in the oval fossa in 89 patients. Of these patients, 18 (20%) had residual defects. At 6 or 12 months following placement of the device, 13 defects (14.6%) had persisted. We evaluated several variables derived from clinical features, transesophageal echocardiography and catheterization to establish predictors for residual shunting. Results: Multivariate analysis identified a shorter superior rim of less than 8 mm (Odds ratio = 10.1; 95% confidence intervals = 2.64–38.72; p = 0.001), and a smaller interatrial septum in the 30-degree transesophageal echocardiographic plane of less than 30 mm (Odds ratio = 5.5; 95% confidence intervals = 1.17–26.14; p = 0.03) as independent predictors of residual defects. When the analysis was repeated defining only those 13 patients with persisting residual defects at 6 or 12 months as failures, a short superior rim (p = 0.004) remained a predictor for residual shunting. Conclusions: Defects with a short superior rim and smaller interatrial septum in the 30-degree transesophageal echocardiographic plane independently and additively predict an increased probability of residual shunting following closure of defects in the oval fossa using the Amplatzer device.

Keywords

Atrial septal defectinterventional catheterizationechocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 4 , August 2003 , pp. 352 - 360
Copyright
© 2003 Cambridge University Press

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