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The Amplatzer septal occluder

Published online by Cambridge University Press:  19 August 2008

Kevin P. Walsh  and
Ismail M. Maadi
Kevin P. Walsh
Affiliation:
Our Lady's Hospital for Sick Children, Crumlin, Dublin, Republic of Irela
Ismail M. Maadi
Affiliation:
Our Lady's Hospital for Sick Children, Crumlin, Dublin, Republic of Irela
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Abstract

The Amplatzer Septal Occluder is made from a Nitinol wire mesh shaped into 2 disks with a connecting waist, which serves to center the device in the defect while occluding it. The Amplatzer device is also available in a configuration with no central waist for use in patients with patent oval foramen, or multiperforated aneurysm of the interatrial septum. For the purposes of this review, we analysed our experience using the Amplatzer device in 150 patients with interatrial communications. Of these, 104 had a defect within the oval fossa, 33 a patent oval foramen, and 13 had undergone fenestration of a Fontan procedure. Of those with defects within the oval fossa, a device was implanted in 100 patients, and 2 of these patients subsequently required surgical intervention, 1 because of migration and the other because of malformation of the device. Of the remaining 98 patients, complete occlusion has been achieved in 90% at 1 year. Any residual leaks are either trivial or small. In those with a patent oval foramen, the septal occluder was used to close 20, whilst the device designed specifically for this purpose was used in 13. On follow-up contrast echocardiography, only 2 patients have a small residual right-to-left shunt. Complete occlusion was achieved for all the Fontan fenestrations, although 1 patient later underwent surgery for baffle dehiscence. Other significant complications occurred in 2 patients who developed deep vein thrombosis, and 3 patients who suffered transient supraventicular arrhythmias. Although the Amplatzer device has been in clinical use for only 3 years, its unique design, and ease of use, has resulted in its widespread adoption by many entres. The results to date are very encouraging, but it must be remembered that there is, as yet, no long-term followup data available for this life-long implant.

Keywords

Atrial septal defectpatent oval foramenFontan fenestrationinterventional cardiology
Type
Research Article
Information
Cardiology in the Young , Volume 10 , Issue 5 , September 2000 , pp. 493 - 501
Copyright
Copyright © Cambridge University Press 2000

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