Transcatheter Occlusion of Secundum Atrial Septal Defects with Latest Generation Coated Nitinol Wire Devices

Background:

Transcatheter occlusion of secundum atrial septal defects using commercial available devices is a safe and effective procedure. We present our experience with two new generation coated nitinol wire devices.

Methods:

We report device characteristics, implantation technique and outcomes of patients with atrial septal defects treated with the Lifetech CERA^TM ASD Occluder and the Cocoon Septal Occluder.

Results:

Procedures were performed in 49 patients, 37 were female. Ages ranged from 7 to 68 years and body weight from 17 to 90 kg. The aortic rim was present in 34.7% and atrial septal aneurysms in 14.3% of the patients. Mean diameter was 13 ± 7 mm whereas the balloonstretched diameter was 22 ± 7 mm. Implantation was possible in all cases and 55 devices were used. Fortyfive CERA^TM and four Cocoon devices were used. Three patients required occlusion of a second orifice. During the procedures the first device had to be replaced by a larger one in two cases, and in the third case it was replaced due to a tuliplike malformation of the left atrial disc. Immediate occlusion occurred in 91.9% and in 95.9% at 6 months. There were no deaths or other significant complications.

Conclusions:

The use of both CERA^TM and Cocoon devices was simple and reproducible in experienced hands. Shortterm occlusion rates were similar to the ones obtained with the Amplatzer^TM device. More studies and longterm followup are required to determine the actual advantages of coated nitinol wire devices.

Heart septal defects, atrial; Cardiac catheterization; Prostheses and implants