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Predictors of residual defects following closure of defects in the oval fossa using the Amplatzer device: echocardiography recapitulates morphometry

Published online by Cambridge University Press:  24 May 2005

Duraisamy Balaguru ,
Robert H. Anderson ,
Geoffrey L. Rosenthal ,
Andrew C. Cook ,
Wolfgang A.K. Radtke  and
Girish S. Shirali
Duraisamy Balaguru
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, USA
Robert H. Anderson
Affiliation:
Institute of Child Health, University College, London, United Kingdom
Geoffrey L. Rosenthal
Affiliation:
Cleveland Clinic Foundation, Cleveland, Ohio, USA
Andrew C. Cook
Affiliation:
Institute of Child Health, University College, London, United Kingdom
Wolfgang A.K. Radtke
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, USA
Girish S. Shirali
Affiliation:
Department of Pediatrics (Cardiology), Medical University of South Carolina, Charleston, South Carolina, USA
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Abstract

Objectives: This study was designed to identify predictors of residual defects following deployment of the Amplatzer device to close septal defects within the oval fossa. Methods: Between February 1997 and February 2000, we used the Amplatzer device to close defects in the oval fossa in 89 patients. Of these patients, 18 (20%) had residual defects. At 6 or 12 months following placement of the device, 13 defects (14.6%) had persisted. We evaluated several variables derived from clinical features, transesophageal echocardiography and catheterization to establish predictors for residual shunting. Results: Multivariate analysis identified a shorter superior rim of less than 8 mm (Odds ratio = 10.1; 95% confidence intervals = 2.64–38.72; p = 0.001), and a smaller interatrial septum in the 30-degree transesophageal echocardiographic plane of less than 30 mm (Odds ratio = 5.5; 95% confidence intervals = 1.17–26.14; p = 0.03) as independent predictors of residual defects. When the analysis was repeated defining only those 13 patients with persisting residual defects at 6 or 12 months as failures, a short superior rim (p = 0.004) remained a predictor for residual shunting. Conclusions: Defects with a short superior rim and smaller interatrial septum in the 30-degree transesophageal echocardiographic plane independently and additively predict an increased probability of residual shunting following closure of defects in the oval fossa using the Amplatzer device.

Keywords

Atrial septal defectinterventional catheterizationechocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 4 , August 2003 , pp. 352 - 360
Copyright
© 2003 Cambridge University Press

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References

Walsh KP, Maadi IM. The Amplatzer septal occluder. Cardiol Young 2000; 10: 493–501.Google Scholar
Carminati M, Giusti S, Hausdorf G, et al. A European multicentric experience using the CardioSEAL and Starflex double umbrella devices to close interatrial communications holes within the oval fossa. Cardiol Young 2000; 10: 519–526.Google Scholar
Godart F, Rey C, Francart C, et al. Experience in one center using the buttoned device for occlusion of atrial septal defect: comparison with the Amplatzer septal occluder. Cardiol Young 2000; 10: 527–533.Google Scholar
Momenah TS, McElhinney DB, Brook MM, Moore P, Silverman NH. Transesophageal echocardiographic predictors of successful transcatheter closure of defects within the oval fossa using the CardioSEAL septal occlusion device. Cardiol Young 2000; 10: 510–518.Google Scholar
Stumper O, Witsenburg M, Sutherland GR, Cromme-Dijkhuis A, Godman MJ, Hess J. Transesophageal echocardiographic monitoring of interventional cardiac catheterization in children. J Am Coll Cardiol 1991; 18: 1506–1514.Google Scholar
Tardif JC, Vannan MA, Pandian NG. Biplane and multiplane transesophageal echocardiography: methodology and echo-anatomic correlations. Am J Card Imaging 1995; 9: 87–99.Google Scholar
Seward JB. Biplane and multiplane transesophageal echocardiography: evaluation of congenital heart disease. Am J Card Imaging 1995; 9: 129–136.Google Scholar
Thanopoulos BD, Laskari CV, Tsaousis GS, Zarayelyan A, Vekiou A, Papadopoulos GS. Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol 1998; 31: 1110–1116.Google Scholar
Sharafuddin MJA, Gu X, Titus JL, Umess M, Cervera-Ceballos JJ. Transvenous closure of secundum atrial septal defects. Preliminary results of a new self-expanding Nitinol prosthesis in a swine model. Circulation 1997; 95: 2162–2168.Google Scholar
Gutgesell HP, Rembold CM. Growth of the human heart relative to body surface area. Am J Cardiol 1990; 65: 662–668.Google Scholar
Martins JDF, Anderson RH. The anatomy of interatrial communications – what does the interventionist need to know? Cardiol Young 2000; 10: 464–473.Google Scholar