Atrial septal defect percutaneous closure

Atrial Septal Defect Microchapters
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Ostium Secundum Atrial Septal Defect
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Sinus Venosus Atrial Septal Defect
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Claudia Hochberg, M.D.

Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]; Priyamvada Singh, MBBS [[4]]

Assistant Editor-In-Chief: Kristin Feeney, B.S. [[5]]

Overview

Percutaneous transcatheter closure is used in limited atrial septal defect cases. The Food and Drug Administration has only authorized the use of percutaneous closure in ostium secundum patients.

Percutaneous closure

Percutaneous transcatheter closure is current only indicated for the closure of ostium secundum atrial septal defects. It should not be used in patients with sinus venosus, primum or patent foramen ovale atrial septal defects. In patients with a secundum defect, there must be a sufficient rim of tissue around the septal defect.

The Food and Drug Administration has authorized the following percutaenous transcatheters for usage:

• Amplatzer septal occluder
• CardioSEAL
• HELEX septal occluder
• Sideris patch

The Ampltazer septal occluder (ASO) is the most commonly used device as it allows closure of large cavities, is easy to implant, and boasts high success rates. As an instrument, the ASO consists of two self-expandable round discs connected to each other with a 4-mm waist, made up of 0.004–0.005´´ nitinol wire mesh filled with Dacron fabric. Implantation of the device is relatively easy. The prevalence of residual defect is low. The disadvantages are a thick profile of the device and concern related to a large amount of nitinol (a nickel-titanium compound) in the device and consequent potential for nickel toxicity.

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