AMPLATZER ASD CLOSURE DEVICE USED IN ADULTS.
B Hockings*, J Wilkinson & C Blanton
Cardiology Departments, Sir Charles Gairdner Hospital and Mount Hospital, Perth & Royal Childrens Hospital, Melbourne. On behalf of the participating Cardiologists.
The Amplatzer ASD (Atrial Septal Defect) closure device was first used in Australia in November 1996. A review of the Australian experience with the device when used in adult (> 16 years) patients has been undertaken. All Australian operators have been surveyed to assess success rate, complications and follow-ups. One operator declined to participate. Thirty-four (Information on 28) devices have been used by 10 Cardiologists in 7 hospitals.
The procedure has been attempted in 34 patients (8 male) aged 16 to 73. The device sizes ranged from 12mm to 34mm. In 20 patients the device was deployed successfully at the first attempt, a further 3 patients had the device successfully deployed at a subsequent attempt. In 4 patients the device could not be deployed and was withdrawn without complication. In one patient embolisation of the device occurred to the descending aorta; the device was retrieved percutaneously via the left femoral artery.
Follow up, to date, averages 4 months (.25 to 19 months). Of the 23 patients in whom the device has been successfully deployed, to date, 6 have improved symptomatically and in 8 the right heart chambers have decreased in size. None of the patients has had any significant residual shunting detected by echocardiography.
The Australian experience is that the Amplatzer ASD closure device can be used successfully in adult patients, with a low rate of complications, but so far it has proved difficult to select those patients with larger defects in whom the device can be successfully deployed.
