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asd closure device

Zakaria Jalal, Pierre-Emmanuel Seguela, Alban-Elouen Baruteau, David Benoist, Olivier Bernus, Olivier Villemain, Younes Boudjemline, Xavier Iriart, Jean-Benoit Thambo
As for any preclinical development of new implantable device, bench testing has been followed by experimental studies on large animal models for the development of atrial septal defect closure devices. Various models have been used according to studied species (porcine, ovine or canine model) and whether the septal defect was percutaneously or surgically created. Animal models of percutaneous atrial septal defect closure aim to assess the healing process and device endothelialisation, as well as the development of magnetic resonance imaging guided procedures, the short-term effects of volume overload on right ventricular contractility through haemodynamic studies and the understanding of other complications such as nickel hypersensitivity...
September 2018: Journal of Thoracic Disease
Matthew R Williams, James C Perry
Atrial septal defects (ASDs) are the most common form of congenital heart disease. There are 4 embryologic types of ASDs, and rhythm considerations vary based on type. ASDs have left-to-right shunt and primarily right-sided volume overload. This leads to electrical remodeling that may predispose patients to atrial tachyarrhythmias and conduction disorders. Risk for arrhythmias is increased with late age of ASD repair, shunt size, other factors such as pulmonary hypertension and comorbid conditions. Arrhythmia incidence is decreased after ASD closure, but remains elevated compared to general population...
September 2018: Journal of Thoracic Disease
Alessia Faccini, Gianfranco Butera
Transcatheter closure is a widespread technique used to treat secundum atrial septal defects (ASDs). When compared to surgery, it provides a less invasive approach with quicker recovery and reduced physical and psychological impact. Nowadays, almost 85-90% of all secundum ASD can be closed by using a transcatheter approach. However, several limitations may have a significant impact on the feasibility and success of percutaneous ASD closure. Limitations can be grouped as: (I) anatomical; (II) device-related; (III) associated defects and natural history associated issues; (IV) physiological; (V) complications...
September 2018: Journal of Thoracic Disease
Se Yong Jung, Jae Young Choi
There has been a remarkable improvement in the treatment strategy of secundum atrial septal defect (ASD) over the last few decades. Indebted to the improvement in device technology and procedural techniques, transcatheter closure of ASD is currently accepted as the treatment of choice in most patients with secundum ASD. Recent generation devices enable easy and safe deployment of device with the properties of adequate flexibility, re-capturability and repositioning. Use of biocompatible materials with improved device design and refined equipment finish may promote re-endothelialization and reduce potential damage to nearby structures...
September 2018: Journal of Thoracic Disease
Bushra S Rana
Transcatheter procedures offer less invasive approaches allowing rapid recovery and earlier hospital discharge. A number of international guidelines have defined the role of echocardiography spanning diagnosis, detailed anatomical assessment, device sizing and selection, peri-procedure guidance and post device surveillance. This review discusses the role of echocardiography in transcatheter atrial septal defect (ASD) closure. It describes a systematic approach to assessment including the crucial role of three dimensional echo and provides the reader with key information required during device sizing and procedure guidance...
September 2018: Journal of Thoracic Disease
Shreepal Jain, Bharat Dalvi
Patients having atrial septal defect (ASD) with moderate and more importantly severe pulmonary arterial hypertension (PAH) pose a clinical dilemma. Closing ASD in those with irreversible PAH and not closing it when the PAH is reversible can cost patients dearly, both in terms of quality of life and longevity. In our experience, there is no single parameter that can help in decision making in this difficult subset of patients and therefore we recommend a multi-dimensional approach, which takes into consideration clinical, radiological, electrocardiographic and hemodynamic variables as a whole...
September 2018: Journal of Thoracic Disease
Alejandro Javier Torres
Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies. ASD can present as an isolated lesion in an otherwise normal heart or in association with other congenital heart conditions. Regardless of the type of ASD, the direction and degree of shunting across the communication is mainly determined by the difference in compliance between the right and left ventricle. Hemodynamics in children is characterized by left-to-right shunting, dilated right heart structures and normal pulmonary artery pressures (PAP)...
September 2018: Journal of Thoracic Disease
Alain Fraisse, Monica Latchman, Shiv-Raj Sharma, Selin Bayburt, Pascal Amedro, Giovanni di Salvo, Alban Elouen Baruteau
Transcatheter closure has become an accepted alternative to surgical repair for ostium secundum atrial septal defects (ASD). However, large ASDs (>38 mm) and defects with deficient rims are usually not offered transcatheter closure but are referred for surgical closure. Transcatheter closure also remains controversial for other complicated ASDs with comorbidities, additional cardiac features and in small children. This article not only provides a comprehensive, up-to-date description of the current indications and contra-indications for ASD device closure, but also further explores the current limits for transcatheter closure in controversial cases...
September 2018: Journal of Thoracic Disease
Quang Binh Truong, Anh Quoc Dao, Nguyen Tin Do, Minh Khoi Le
Femoral venous approach is the classic route of percutaneous atrial septal defect (ASD) closure. But in patients with interrupted inferior vena cava (IVC) with azygos continuation the normal connection is lost rendering transcatheter intervention more complicated and innovative approaches should be sought. Transhepatic approach has been used with success but this approach is technically demanding and could lead to major complications. We report successful percutaneous secundum ASD closure in 2 patients with interrupted IVC...
September 2018: Journal of Cardiology Cases
Ashwin K Thiagaraj, Richard Bloomingdale, Tesfaye Telila, Luis C Afonso
The HELEX septal occluder (W.L. Gore & Associates, Newark, DE, USA) is a popular closure device for patent foramen ovale (PFO) and secundum atrial septal defect (ASD). Composed of a versatile polymer and a wire frame, it has been used for nearly a decade. A 50-year-old African American man with a PFO repaired 5 years previously with the HELEX was admitted to our hospital with methicillin-resistant Staphylococcus aureus bacteremia. A transesophageal echocardiogram demonstrated large mobile vegetations on the left and right atrial aspects of the occluder...
December 2017: Journal of Cardiology Cases
Gianluca Rigatelli, Marco Zuin, Nguyen Tuong Nghia
Interatrial shunt closure is considered the first-line therapy for congenital simple communications such as patent forame ovale (PFO), atrial septal defect (ASD), and post surgical interatrial communications. Areas covered: Anatomical, functional, and technical details useful for planning a transcatheter-based closure procedure are discussed as well as the available equipments and their use and the procedural routes and the specific closure techniques. Expert commentary: Anatomical and functional details, appreciated at both pre-procedural and intraprocedural steps, are of paramount importance for planning interatrial shunts transcatheter - based closure procedures...
September 22, 2018: Expert Review of Medical Devices
Vincenzo Tufaro, Gianfranco Butera
We report on three cases of atrial septal defect (ASD) closure where a handmade fenestration had to be modified after device implantation. Two patients suffered from left ventricular diastolic dysfunction and one had severe pulmonary arterial hypertension. Amplatzer ASD occluder fenestration was created in all patients. Devices were implanted using an "over-the-wire" implantation technique. Due to a sub-optimal hemodynamic result, fenestration was upsized by using a new technique.
September 9, 2018: Catheterization and Cardiovascular Interventions
Manav Aggarwal, Kumaraswamy Natarajan, Maniyal Vijayakumar, Rajiv Chandrasekhar, Navin Mathew, Vikrant Vijan, Anjith Vupputuri, Sanjeev Chintamani, Bishnu Kiran Rajendran, Rajesh Thachathodiyl
OBJECTIVE: The study investigated effectiveness of transcatheter closure of post-myocardial infarction (MI) ventricular septal rupture (VSR) using atrial septal device (ASD) occluder in a cohort of patients admitted at our institute. METHOD: This was a retrospective, observational and single center study, which included patients who were treated with transcatheter closure for post-MI VSR at our tertiary care center between May 2000 and August 2014 depending upon inclusion and exclusion criteria...
July 2018: Indian Heart Journal
Wei-Ze Xu, Xin-Yi Shou, Jian-Hua Li, Jian-Gen Yu, Ze-Wei Zhang, Jin Yu, Jing-Jing Ye
BACKGROUND: This study sought to investigate the feasibility, safety and effectiveness of transcatheter closure of atrial septal defects (ASDs) under the guidance of transesophageal echocardiography (TEE) in children. METHODS: We reviewed the medical records of patients who underwent percutaneous ASD closure at our center from August 2016 to December 2017. For a total of 88 patients who were identified as having a single-hole defect and were undergoing percutaneous transcatheter ASD closure, a procedure completely guided by TEE was performed...
August 2018: World Journal of Pediatrics: WJP
Jackson J Liang, Sanghamitra Mohanty, Joe Fahed, Daniele Muser, David F Briceno, J David Burkhardt, Jeffrey S Arkles, Gregory E Supple, David S Frankel, Saman Nazarian, Fermin C Garcia, David J Callans, Sanjay Dixit, Luigi Di Biase, Andrea Natale, Francis E Marchlinski, Pasquale Santangeli
OBJECTIVES: This study reports outcomes of bailout atrial balloon septoplasty (ABS) to overcome challenging left atrial (LA) access in patients undergoing atrial fibrillation (AF) ablation. BACKGROUND: Transseptal puncture (TSP) and LA access for AF ablation can be challenging in patients with prior atrial septal surgery, percutaneous closure, or scarred septum due to multiple prior TSPs. METHODS: The study identified patients who underwent AF ablation at 2 ablation centers from 2011 to 2017 with challenging TSP in whom bailout percutaneous ABS was performed to allow LA access...
August 2018: JACC. Clinical Electrophysiology
Antonio Vitarelli, Enrico Mangieri, Carlo Gaudio, Gaetano Tanzilli, Fabio Miraldi, Lidia Capotosto
PURPOSE: The purpose of this study was to examine right atrial (RA) function by two-dimensional (2DSTE) and three-dimensional (3DSTE) speckle-tracking echocardiography in patients with atrial septal defect (ASD) who had implantation of septal occluders and developed paroxysmal atrial fibrillation (PAF). METHODS: Seventy-three patients with hemodynamically significant secundum ASD were prospectively studied and followed up for six months after occluder insertion and compared with a normal age-matched group(n=73)...
August 17, 2018: Clinical Cardiology
Wenxin Lu, Wenbin Ouyang, Shouzheng Wang, Yao Liu, Fengwen Zhang, Weiwei Wang, Xiangbin Pan
OBJECTIVE: To evaluate the feasibility, efficacy, and safety of a fully biodegradable poly lactic acid (PLA)-based occluder for atrial septal defect (ASD) closure in an animal model. METHODS: ASDs, approximately 12-mm in diameter, were generated in sheep (n = 18) by needle puncture and balloon dilatation. For ASD closure, occluders were implanted by percutaneous transcatheter approach under echocardiographic guidance. Outcomes were evaluated by transthoracic echocardiography, electrocardiography, blood testing, and histology within the follow-up period ranging from 1 month to 2 years...
August 5, 2018: Journal of Interventional Cardiology
Ming-Chun Yang, Jiunn-Ren Wu
Atrial septal defect (ASD) is one of the two most common congenital heart diseases in children and adult. After the application of catheter intervention for ASD, this became an alternative treatment other than surgery from late 1990. In 2001, the procedure was further approved by the US Food and Drug Administration (FDA), and become the first choice for most cases of secundum type of ASD worldwide. The success rate is more than 98% in literature reviews, with low complication rates in percutaneous ASD closure...
July 2018: Kaohsiung Journal of Medical Sciences
Ahmet Öz, Emre Aruğaslan, Tufan Çınar, Muhammed Keskin, Mert Ilker Hayıroğlu, Şahin Avşar, Mehmet Baran Karataş, Berat Arıkan Aydın, Koray Demir, Barış Güngör, Osman Bolca
Some studies have been showed that electromechanical delay, which may pose an increased tendency to atrial fibrillation, may prolong in patients with various clinical conditions. In addition, the electromechanical delay in patients with secundum type atrial septal defect (ASD) compared to healthy people have been reported previously. Therefore, in the present study, we prospectively evaluated the mid-term and long-term effects of the transcatheter closure of secundum type ASD on the lateral atrial conduction time (PA), septal PA, tricuspid PA, left and right intra-atrial electromechanical delay (ILeft-EMD and IRight-EMD, respectively) and inter-atrial electromechanical delay (IA-EMD) measured by means of Doppler echocardiography...
July 30, 2018: International Journal of Cardiovascular Imaging
Yao Liu, Gai-Li Guo, Feng-Wen Zhang, Bin Wen, Wen-Bin Ou-Yang, Yong-Quan Xie, Xiang-Bin Pan
Objective: To assess the effectiveness of a novel ultrasound wire for echo-guiding percutaneous atrial septal defect (ASD) closure in a sheep model. Methods: After right lateral thoracotomy, ASDs were created in 20 sheep by transseptal needle puncture followed by balloon dilatation. Animals were evenly randomized into 2 groups to undergo ASD closure using echography as the only imaging tool with either COOK wire (control group) or new ultrasound wire (study group)...
2018: Journal of Healthcare Engineering
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