[Correction of the perpendicular positioning of the Amplatzer device during closure of an ostium secundum atrial septal defect]. / Corrección de la posición perpendicular del oclusor Amplatzer en el cierre percutáneo de la comunicación interauricular ostium secundum.

INTRODUCTION AND OBJECTIVES: Ostium secundum atrial septal defects require closure. Echocardiographic studies have reported that, in 7% of cases, the Amplatzer occluder is orientated perpendicular to the rim of the defect. This article describes the use of an ancillary technique involving a balloon catheter that enables the Amplatzer device to be positioned transversely. METHODS: We report six patients with an ostium secundum atrial septal defect in whom echocardiographic imaging showed that the Amplatzer device was positioned perpendicular to the rim of the defect. To correct the device's orientation, we used an ancillary maneuver that involved placing a balloon catheter at the device's lower edge, thereby inducing it to adopt a transverse position and undergo successful implantation. RESULTS: In all cases, the ancillary balloon catheter technique enabled the device to adopt the correct transverse orientation, thereby facilitating successful implantation. CONCLUSIONS: The ancillary balloon catheter technique is useful for ensuring that Amplatzer devices adopt a transverse orientation when echocardiography shows the device to be persistently orientated perpendicular to the rim of the septal defect.

Corrección de la posición perpendicular del oclusor Amplatzer en el cierre percutáneo de la comunicación interauricular ostium secundum / Correction of the Perpendicular Positioning of the Amplatzer Device During Closure of an Ostium Secundum Atrial Septal Defect

Introducción y objetivos. La comunicación interauricularostium secundum (CIAOS) es una afección que requierecierre del defecto. Se han publicado imágenesecocardiográficas con la posición perpendicular del oclusor Amplatzer en el 7% de los casos. En este documento describimos una técnica de apoyo con balón que permite la presentación transversa del dispositivo.Métodos. En 6 pacientes con diagnóstico de CIAOS seobservó mediante imágenes ecocardiograficas la posiciónperpendicular del dispositivo sobre los bordes deldefecto. Para corregir esta posición, aplicamos una maniobra de apoyo con balón sobre el borde inferior del dispositivo para favorecer la posición transversa y su implantación.Resultados. En todos los casos, la maniobra de apoyocon balón permitió la correcta presentación transversadel dispositivo, favoreciendo su implantación.Conclusiones. La técnica de apoyo con balón es unaalternativa útil que permite la posición transversa del dispositivo Amplatzer cuando en imágenes ecocardiográficas el dispositivo mantiene una posición persistentemente perpendicular sobre los bordes del defecto

Introduction and objectives. Ostium secundum atrialseptal defects require closure. Echocardiographic studieshave reported that, in 7% of cases, the Amplatzeroccluder is orientated perpendicular to the rim of thedefect. This article describes the use of an ancillarytechnique involving a balloon catheter that enables theAmplatzer device to be positioned transversely.Methods. We report six patients with an ostiumsecundum atrial septal defect in whom echocardiographicimaging showed that the Amplatzer device waspositioned perpendicular to the rim of the defect. Tocorrect the device’s orientation, we used an ancillarymaneuver that involved placing a balloon catheter at thedevice’s lower edge, thereby inducing it to adopt atransverse position and undergo successful implantation.Results. In all cases, the ancillary balloon cathetertechnique enabled the device to adopt the correct transverse orientation, thereby facilitating successful implantation.Conclusions. The ancillary balloon catheter techniqueis useful for ensuring that Amplatzer devices adopt atransverse orientation when echocardiography shows thedevice to be persistently orientated perpendicular to therim of the septal defectfa