Individualized application of occluder in transcatheter closure of multi-fenestrated atrial septal defects / 中国介入心脏病学杂志

ABSTRACT

Objective To evaluate the impact of individualized occluder application on efficacy and complications of transcatheter closure treatment for multi-feneatrated atrial septal defects (mfASD).Methods Seventy six patients with mfASD who were hospitalized at Fudan University Zhongshan Hospital from July 2006 to July 2015 were retrospectively enrolled.Clinical and follow-up data were collected and analyzed.Results Among the 76 patients including 18 males and 58 females,transcatheter closure was successfully performed in 73 patients (96.1%).The morphological features of ASD included: 60 cases (78.9%) with two defects and 16 cases (21.1%) with cribriform defects, 3 cases (3.9%) combined with patent foramen ovale (PFO),13 cases (17.1%) with atrial septal aneurysm (ASA).Dual occluders were used for closure in 26 patients (35.6%),while single occluder was implanted in 47 patients (64.4%).In single-occluder group,measuring balloon was used to assist occlusion in 7 patients (14.9%).3 patients versus 11 patients required the small-waist-big-edge occluders in the dual-occluder group and the single-occluder group respectively (11.5% vs.23.4%, P=0.352).The complication rate in the dual-occluders group was higher than that in the single-occluder group (19.2% vs.4.3%, P=0.037),while the incidence of residual shunt showed no significant difference between these two groups (11.5% vs.10.6%, P=0.906).Conclusions The occluder for transcatheter closure of multiple atrial septal defects needs to be individually chosen according to the morphological characters.Transcatheter closure of mfASD using two devices is feasible,safe and effective for selected patients.