Introduction: A transcatheter closure of atrial septal defect(ASD)with the Amplatzer septal occluder(ASO)is a newperspective non-surgical method of treatment of this congenitalheart defect.The aim of the study was to determine the rate of suitable defectsfur this new non-surgical techuique.Patients and methods:From9/95-9/97,77 patients with secundum ASD underwent an attemptat transcatheter closure;.at a median age of 9.3 yr.(range,2.1-43.5 yr.)and meaian weight of 32 kg(range,13-68kg).The most important echocardiograghic criteria for successfulctosure are sufficient rims around the defect,diameter ot medefect and total length of atrial septum.3 pts which not fulfilcriteria were excluded from transthoracic echocardiograpny(TTE).11 pts were excluded from transesophageal TTE,2 ptswere excluded during intervention.we evaluate this results anacompare it with the values frrom perioperative morphomethry otASD’s in 353 patients who underwent surgety(years-90).Results:The medlian ASD size measured by TEE was 11.7 mm(range,5-23 mm)and the median stretched diameter was 13.9mm(range,5-24 mm).All devices were placed correctly.Therewas no complication related to the closure.On a median follow-up interval of 8.5 months(range 0.4-2.2 yr)there has been noepisodes of endocarditis,thromboembofism or wire fracture and58/61 pts(95%)had complete closure,as assessed by TTE.Conclusion From 77 patiehts 61 fulfil criteria and successfullyunderwent a transcathter closure of ASD,which represents 79%.In 353 patients who underwent surgery authors compare the areaof the defect and the septal area.278 pts(78%)had suitabledefect for transcatheter closure.We conclude that a new selfexpandable,repositionable ASO is affording a safe and defectivemethod to close small-large secundum ASD’s.Suitable defectsfor this procedure are in the majority(up to 80%)of patients withsecundum ASD.
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