(Circulation. 1997;95:2162-2168.)
© 1997 American Heart Association, Inc.
Articles |
Transvenous Closure of Secundum Atrial Septal Defects
Preliminary Results With a New Self-Expanding Nitinol Prosthesis in a Swine Model
From the Departments of Radiology (M.J.A.S., X.G., M.U., J.J.C.-C., K.A.) and Pathology-Laboratory Medicine (J.L.T.), University of Minnesota Hospital and Clinic (Minneapolis), and The Jesse E. Edwards Registry of Cardiovascular Disease (J.L.T.), United Hospital, St Paul, Minn.
Correspondence to Kurt Amplatz, MD, Section of Cardiovascular and Interventional Radiology, Department of Radiology, University of Minnesota Hospital and Clinic, Box 292-Mayo, 420 Delaware St, SE, Minneapolis, MN 55455. E-mail sharafuddinm{at}mirlink.wustl.edu
Background Our purpose was to evaluate a new prosthesis for percutaneous closure of secundum atrial septal defects (ASDs).
Methods and Results Percutaneous closure of surgically created fossa ovalis ASD was attempted in 15 minipigs. The mean balloon-stretched ASD diameter was 12.3±2.3 mm (range, 10 to 16 mm). The self-expanding prosthesis was braided from 0.005-in Nitinol wires in the shape of two flat buttons with a short connecting waist with a diameter corresponding to that of the defect to be closed. Polyester filling was added to enhance thrombogenicity. Pulmonary arteriography with levo-phase was obtained before placement; immediately after placement; and at 1-week, 1-month, and 3-month follow-ups. Four animals were killed at 1 week, 1 month, and 3 months for histopathological correlation. Three deaths resulted from ventricular fibrillation (one during anesthesia and two during the placement procedure). Successful placement of the prosthesis was achieved in the remaining 12 animals. Overall immediate ASD closure on angiography occurred in 7 of 12 animals (all polyester-filled prostheses). Absent or trace shunt by angiography was present in 11 of 12 devices at 1 week, with the remaining one demonstrating a small shunt. All septal defects were completely closed at 1 month with the exception of one case in which delayed partial dislodgment of an undersized prosthesis into the right atrium had developed. Closure rate at 3 months was 100%. Neoendothelialization and fibrous incorporation of the prosthesis were completed within 1 to 3 months.
Conclusions Effective and permanent occlusion of secundum ASDs is feasible with a device that offers the advantages of easy placement, self-centering, and repositionability.
Key Words: heart septal defects • heart defects, congenital • pediatrics • shunts
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|
|
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|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|