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Safety of Occlutech Septal Occluder ACCELL Flex II for Transcatheter Closure of Secundum Atrial Septal Defects in Children: A Long-Term Follow-Up. J Interv Cardiol 2022; 2022:8886813. [PMID: 35069039 PMCID: PMC8752296 DOI: 10.1155/2022/8886813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives. To assess the long-term safety and efficacy of the Occlutech® ACCELL® Flex II device used for atrial septal defect (ASD) closure. This device differs from the regular device by having two very thin patches that are made of polyethylene terephthalate (PET). These patches enhance faster sealing of the defect. Background. Transcatheter closure has become the method of choice to manage most patients with secundum ASDs. There are different types of devices. The regular Occlutech device used to close an ASD is called the Occlutech Figulla Flex II. A newer modification of this device (Occlutech® ACCELL® Flex II) has been designed to eliminate/reduce thrombus formation and to enhance faster sealing. Methods. Thirty patients were followed up after occlusion of secundum ASD using the Occlutech® ACCELL® Flex II Device. The follow-up period ranged from 5.2–5.5 years with median of 5.3 years. Detailed history and full clinical examination, twelve-lead electrocardiogram (ECG), plain chest radiograph, and full 2D transthoracic echocardiography (TTE) were performed at discharge, at one month, six months, and yearly thereafter. Results. The mean age of the study group at the last follow-up was 10.4 ± 4.6 years, with 63.3% (nineteen patients) females. There were no residual shunts or complications encountered immediately after the procedure and at the latest follow-up. Conclusion. This study confirmed the transcatheter closure (TCC) of secundum ASDs using the Occlutech® ACCELL® Flex II device to be safe and effective with no complications detected in children and adolescents.
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Nakayama R, Takaya Y, Akagi T, Watanabe N, Miki T, Nakagawa K, Toh N, Ito H. Efficacy and safety of atrial septal defect closure using Occlutech Figulla Flex II compared with Amplatzer Septal Occluder. Heart Vessels 2021; 36:704-709. [PMID: 33386412 DOI: 10.1007/s00380-020-01739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/20/2020] [Indexed: 11/25/2022]
Abstract
Few studies have reported the efficacy of Occlutech Figulla Flex II (FFII) device compared with Amplatzer Septal Occluder (ASO) device. The aim of this study was to examine the efficacy and safety of FFII compared with ASO for transcatheter atrial septal defect (ASD) closure. We retrospectively evaluated 190 patients using FFII and 190 patients using ASO who underwent transcatheter ASD closure. ASD characteristics were evaluated by transesophageal echocardiography. The prevalence of procedural complications, including erosion, device embolization, stroke, and new-onset atrial arrhythmia, and the presence of a residual shunt were evaluated between the two groups during 12-month follow-up. FFII was used more frequently than ASO in patients with a deficient aortic rim or septal malalignment (P = 0.02, P < 0.01, respectively). The procedural complications of erosion, device embolization, and stroke did not occur in any patients. New-onset atrial arrhythmia occurred in 3 patients of the FFII group and 4 patients of the ASO group, and the difference between the two groups was not significant (P = 0.70). A large residual shunt (≥ 3 mm) was observed in 6 patients of the FFII group and 5 patients of the ASO group, and the difference between the two groups was not significant (P = 0.76). FFII was used frequently in patients with high-risk ASD morphology; however, there was no difference in the prevalence of procedural complications or efficacy between patients using FFII and those using ASO.
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Affiliation(s)
- Rie Nakayama
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoichi Takaya
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Teiji Akagi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Nobuhisa Watanabe
- Division of Medical Support, Okayama University Hospital, Okayama, Japan
| | - Takashi Miki
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Norihisa Toh
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Personalized Three-Dimensional Printing and Echoguided Procedure Facilitate Single Device Closure for Multiple Atrial Septal Defects. J Interv Cardiol 2020; 2020:1751025. [PMID: 32410914 PMCID: PMC7201835 DOI: 10.1155/2020/1751025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background To evaluate the feasibility of using a single device to close multiple atrial septal defects (ASDs) under the guidance of transthoracic echocardiography (TTE) and with the aid of three-dimensional (3D) printing models. Methods Sixty-two patients with multiple ASDs were retrospectively analyzed. Thirty of these patients underwent TTE-guided closure (3D printing and TTE group) after a simulation of occlusion in 3D printing models. The remaining 32 patients underwent ASD closure under fluoroscopic guidance (conventional group). Closure status was assessed immediately and at 6 months after device closure. Results Successful transcatheter closure with a single device was achieved in 26 patients in the 3D printing and TTE group and 27 patients in the conventional group. Gender, age [18.8 ± 15.9 (3–51) years in the 3D printing and TTE group; 14.0 ± 11.6 (3–50) years in the conventional group], mean maximum distance between defects, prevalence of 3 atrial defects and large defect distance (defined as distance ≥7 mm), and occluder size used were similarly distributed between groups. However, the 3D printing and TTE group had lower frequency of occluder replacement (3.8% vs 59.3%, p < 0.0001), prevalence of mild residual shunts (defined as <5 mm) immediately (19.2% vs 44.4%, p < 0.05) and at 6 months (7.7% vs 29.6%, p < 0.05) after the procedure, and cost (32960.8 ± 2018.7 CNY vs 41019.9 ± 13758.2 CNY, p < 0.01). Conclusion The combination of the 3D printing technology and ultrasound-guided interventional procedure provides a reliable new therapeutic approach for multiple ASDs, especially for challenging cases with large defect distance.
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Bhattacharjya S, Pillai LS, Doraiswamy V, Satyanarayana RM, Chandrasekaran R, Pavithran S, Sivakumar K. Prospective concurrent head-to head comparison of three different types of nitinol occluder device for transcatheter closure of secundum atrial septal defects. EUROINTERVENTION 2019; 15:e321-e328. [DOI: 10.4244/eij-d-18-01016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kim AY, Jung SY, Chang JY, Jung JW, Choi JY. Early to Mid-Term Follow-Up Outcomes of Percutaneous Closure of Atrial Septal Defects Using Recent Generation Devices: a Single-Center Experience. Korean Circ J 2018; 49:326-335. [PMID: 30808079 PMCID: PMC6428945 DOI: 10.4070/kcj.2018.0278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/27/2018] [Indexed: 11/11/2022] Open
Abstract
Background and Objectives This study aimed to describe our early to mid-term experience with transcatheter atrial septal defect (ASD) closure using the Occlutech Figulla® Flex II device (FSO), Gore® Cardioform septal occluder (GSO), and Amplatzer® septal occluder (ASO) after they were first approved in Korea in 2014, and to compare the three aforementioned kinds of ASD closure devices. Methods Between September 2014 and August 2016, 267 patients underwent transcatheter ASD closure in our institution. Baseline characteristics, hemodynamic features, comorbidities, and procedural success and complication rates were analyzed retrospectively. The unpaired Student t-test or variance analysis was used in the statistical analysis. Results The FSO was most commonly used (n=152, 56.9%), followed by the ASO (n=98, 36.7%) and GSO (n=17, 6.4%). Baseline characteristics and hemodynamic features were similar between the devices, except that the defect size and pulmonary flow-to-systemic flow ratio were lower in the GSO group than in the other groups. Overall, the procedural success rate remained at 100%, and major complication rate was <1%. No late complication occurred during the follow-up. Conclusions The FSO and GSO are feasible, safe options for use in transcatheter ASD closure, and they are comparable to the ASO.
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Affiliation(s)
- Ah Young Kim
- Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se Yong Jung
- Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jenny Yeonsoo Chang
- Department of Biological Basis of Behavior, College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Jo Won Jung
- Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Young Choi
- Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Ali M, Salah El-Din H, Bakhoum S, El-Sisi A, Mahmood K, Farouk H, Kandil H. Feasibility of percutaneous closure of atrial septal defects in adults under transthoracic echocardiography guidance using the Figulla atrial septal defect occluder device. J Saudi Heart Assoc 2018; 30:21-27. [PMID: 29296061 PMCID: PMC5744024 DOI: 10.1016/j.jsha.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/10/2017] [Accepted: 04/06/2017] [Indexed: 11/28/2022] Open
Abstract
Background Closure of atrial septal defect (ASD) among adults under transthoracic echocardiography (TTE) guidance using devices other than the Amplatzer Septal Occluder has not been extensively tested. Aim of work Assessment of the safety and efficiency of secundum ASD closure using the Occlutech Figulla ASD Occluder under TTE guidance in adult patients with hemodynamically significant secundum ASD. Methods Twenty patients (mean age, 32.9 ± 9.7, 75% of them females) were enrolled in the study. All patients underwent TTE and transoesophageal echocardiography (TEE) to assess the characteristics of the ASD prior to percutaneous closure. Procedures were performed using the Figulla Occluder device under both fluoroscopic and TTE guidance. Follow-up clinical and TTE examinations were done at 1, 3, and 6 months following the procedure. Results TTE estimated mean ASD size was 21.7 ± 7.3 mm with adequate rims except for the aortic rim (deficient in one third of cases). Mean device size was 28.1 ± 8.6 mm with mean procedure and fluoroscopic times of 46.2 ± 16.4 and 15.7 ± 5.4 minutes respectively. ASD was successfully closed in all patients. Two patients showed a small residual shunt immediately after the device placement that disappeared by the end of the 2nd followup TTE examination. Transient complications were detected in 2 patients. All patients were asymptomatic during the follow-up period. Conclusion Transcatheter closure of secundum ASD in adults under TTE guidance using the Occlutech Figulla ASD occluder device is safe and effective when performed in a tertiary center and by expert echocardiographers and interventional cardiologists.
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Affiliation(s)
- Mahmoud Ali
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
| | - Hesham Salah El-Din
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
| | - Sameh Bakhoum
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
| | - Amal El-Sisi
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
| | - Kareem Mahmood
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
| | - Heba Farouk
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
| | - Hossam Kandil
- Cardiology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptaEgypt
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Sadiq M, Ur Rehman A, Mehmood A. Successful retrieval of a Figulla Occlutech septal occluder - embolized device stability and potential solutions. Ann Pediatr Cardiol 2016; 9:161-3. [PMID: 27212852 PMCID: PMC4867802 DOI: 10.4103/0974-2069.180672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Go to: We report a case of an atrial septal defect where a Figulla Occlutech device embolized into the right ventricle. As this device has no left atrial hub, we brought the bare device into the inferior vena cava and used a novel two-snare technique to slenderize the device into the sheath. This report highlights additional tips in transcatheter device retrieval.
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Affiliation(s)
- Masood Sadiq
- Department of paediatric cardiology, The Children's Hospital and Punjab Institute of Cardiology, Lahore, Pakistan
| | - Asif Ur Rehman
- Department of paediatric cardiology, The Children's Hospital and Punjab Institute of Cardiology, Lahore, Pakistan
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Haas NA, Soetemann DB, Ates I, Baspinar O, Ditkivskyy I, Duke C, Godart F, Lorber A, Oliveira E, Onorato E, Pac F, Promphan W, Riede FT, Roymanee S, Sabiniewicz R, Shebani SO, Sievert H, Tin D, Happel CM. Closure of Secundum Atrial Septal Defects by Using the Occlutech Occluder Devices in More Than 1300 Patients: The IRFACODE Project: A Retrospective Case Series. Catheter Cardiovasc Interv 2016; 88:571-581. [DOI: 10.1002/ccd.26497] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/13/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Nikolaus A. Haas
- Department for Congenital Heart Defects; Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum; Germany
- Department of Pediatric Cardiology and Intensive Care; Ludwig Maximilians University Munich Campus; Munich Germany
| | - Dagmar B. Soetemann
- Department for Congenital Heart Defects; Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum; Germany
| | - Ismail Ates
- Department of Cardiology; Asfendiyarov Kazakh National Medical University; Almaty Kazakhistan
| | - Osman Baspinar
- Department of Pediatric Cardiology; Faculty of Medicine, University of Gaziantep; Turkey
| | | | | | - Francois Godart
- Département De Cardiologie Infantile Et Congénitale; Centre Hospitalier Régional Et Universitaire De Lille, Faculté De Médecine Lille 2; France
| | - Avraham Lorber
- Division of Pacing and Electrophysiology; Rambam Health Care Campus and Bruce Rappaport, Faculty of Medicine; Haifa Israel
| | - Edmundo Oliveira
- Hospital Das Clinicas, Universida De Federal De Minas Gerais, Belo Horizonte; Minas Gerais Brazil
| | - Eustaquio Onorato
- Cardiovascular Department; Humanitas Gavazzeni Institute; Bergamo Italy
| | - Feyza Pac
- Department of Pediatric Cardiology; Türkiye, Yüksekİhtisas, Training and Research Hospital; Ankara Turkey
| | - Worakan Promphan
- Pediatric Cardiology Unit, Queen Sirikit National Institute of Child Health (QSNICH); Bangkok Thailand
| | - Frank-Thomas Riede
- Department of Pediatric Cardiology; Heart Center, University of Leipzig; Leipzig Germany
| | - Supaporn Roymanee
- Department of Pediatrics; Pediatric Cardiology Unit, Prince of Songkla University; Thailand
| | - Robert Sabiniewicz
- Department of Pediatric Cardiology and Congenital Heart Diseases; Medical University Gdansk; Poland
| | | | | | - Do Tin
- Department of Cardiology, Children's Hospital and, Department of Pediatric; Medicine and Pharmacy University of Ho Chi Minh City; Vietnam
| | - Christoph M. Happel
- Department for Congenital Heart Defects; Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum; Germany
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9
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Pedra CAC, Pedra SF, Costa RN, Ribeiro MS, Nascimento W, Campanhã LOS, Santana MVT, Jatene IB, Assef JE, Fontes VF. Mid-Term Outcomes after Percutaneous Closure of the Secundum Atrial Septal Defect with the Figulla-Occlutech Device. J Interv Cardiol 2016; 29:208-15. [PMID: 26927945 DOI: 10.1111/joic.12284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To evaluate the mid-term outcomes after percutaneous closure of the secundum atrial septal defects (ASD) using the Figulla-Occlutech device (FOD). BACKGROUND Transcatheter closure has become the method of choice for most patients with ASD. Although the FOD may have some advantageous characteristics there is a paucity of data on later outcomes after the use of this relatively new device. METHODS Observational, single arm study including 200 non-consecutive patients who underwent ASD closure between 04/09 and 07/15 in 2 centers. Device performance, deployment technique, and immediate and mid-term outcomes were assessed. RESULTS Median age and weight were 24 years (4-72) and 58 kg (15-92), respectively. Single defects were observed in 171 patients (median size of 19 mm). The remainder had multiple or multifenestrated defects. Implantation of FOD (median size of 24 mm) was successful in all (99%), but 2 patients (1 with deficient postero-inferior rim; 1 with a large ASD for the size of the child). Embolization with device retrieval occurred in 2 (1%). Median follow-up of 36 months was obtained in 172 patients. Serial echocardiographic assessment showed complete closure in all but 2 patients, in whom an additional small non-significant posterior defect was purposely left untouched. There have been no episodes of late arrhythmias, device embolization, cardiac erosion, endocarditis, thromboembolism, wire fracture, or death. CONCLUSIONS Transcatheter closure of ASDs in older children, adolescents, and adults using the FOD was highly successful in a wide range of anatomical scenarios with high closure rates and no complications in mid-term follow-up.
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Affiliation(s)
- Carlos A C Pedra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | - Simone F Pedra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | - Rodrigo N Costa
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | - Marcelo S Ribeiro
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | - Wanda Nascimento
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | - Luis Otávio S Campanhã
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | | | - Ieda B Jatene
- Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
| | - Jorge E Assef
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | - Valmir F Fontes
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.,Hospital do Coração da Associação Sanatório Sírio, São Paulo, Brazil
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Haas NA, Happel CM, Soetemann DB, Hanslik A, Moysich A, Kececioglu D, Laser KT. Optimal septum alignment of the Figulla® Flex occluder to the atrial septum in patients with secundum atrial septal defects. EUROINTERVENTION 2016; 11:1153-60. [DOI: 10.4244/eijy14m12_09] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Roymanee S, Promphan W, Tonklang N, Wongwaitaweewong K. Comparison of the Occlutech ® Figulla ® septal occluder and Amplatzer ® septal occluder for atrial septal defect device closure. Pediatr Cardiol 2015; 36:935-41. [PMID: 25633819 DOI: 10.1007/s00246-015-1103-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
Abstract
The Occlutech(®) Figulla(®) septal occluder (OFSO) is a later-generation double-disk device with few reports of its success rates and complications compared with the Amplatzer(®) septal occluder (ASO), which is the worldwide standard device in percutaneous atrial septal defect (ASD) closure. We recruited and compared the results in 149 patients (76.5 % female) who underwent ASD device closure in our center between January 2003 and June 2012. The patients ranged in age from 2.3 to 77.2 years. There were no statistically significant differences between the two groups regarding patient baseline characteristics and procedure variables. The success rate using either device was excellent (ASO 94.4 % and OFSO 97.4 %; p = 0.43). Although the diameter of the ASD and the pulmonary arterial pressure in the OFSO group were slightly higher than in the ASO group, the median fluoroscopic time in the OFSO group was significantly shorter (ASO 13.7 min; OFSO 9.0 min; p < 0.001). The overall median follow-up time was 3.6 years (interquartile range 2.1-9.0 years). There were no significant differences between the major and minor complications when comparing the two devices. Both devices were safe and effective for percutaneous ASD closures. The OFSO had the benefit of a shorter fluoroscopic time.
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Affiliation(s)
- Supaporn Roymanee
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand,
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12
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Transcatheter closure of atrial septal defect with the Figulla® ASD Occluder: A comparative study with the Amplatzer® Septal Occluder. Arch Cardiovasc Dis 2015; 108:57-63. [DOI: 10.1016/j.acvd.2014.09.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/16/2014] [Accepted: 09/09/2014] [Indexed: 11/21/2022]
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13
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Aytemir K, Oto A, Özkutlu S, Canpolat U, Kaya EB, Yorgun H, Şahiner L, Sunman H, Ateş AH, Kabakçı G. Transcatheter interatrial septal defect closure in a large cohort: midterm follow-up results. CONGENIT HEART DIS 2013; 8:418-27. [PMID: 23601507 DOI: 10.1111/chd.12057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES We evaluated immediate and midterm results of transcatheter closure of atrial septal defects (ASDs) and patent foramen ovale (PFO) using various closure devices. MATERIALS AND METHODS The study included four hundred fourteen patients (one hundred eighty-two men, two hundred thirty-two women; mean age 39 ± 12.3 years; range 17-67 years) who underwent transcatheter closure of secundum ASD (n = 193) or PFO (n = 221). All the patients were evaluated by transthoracic echocardiography and transesophageal echocardiography before the procedure. Transcatheter closure was performed by using Amplatzer (n = 184), Occlutech Figulla (n = 209), or BioSTAR (n = 21) devices. Closure of ASDs was performed under general anesthesia with transesophageal echocardiography guidance, and closure of PFOs was performed under local anesthesia with transthoracic echocardiography guidance. Follow-up controls were at 1, 6, and 12 months and annually thereafter. The median follow-up periods of ASD and PFO patients were 43 and 30 months. RESULTS The mean device size was 19.3 ± 6.2 mm for ASD patients and 24.6 ± 2.6 mm for PFO patients. The mean procedural and fluoroscopy times were 22.3 ± 4.7 and 4.1 ± 1.9 minutes for ASD closure and 12.4 ± 3.2 and 3.1 ± 1.2 minutes for PFO closure, respectively. Procedural device embolization occurred in only two patients (0.48%). During follow-up, recurrent embolic events occurred in four patients (1.8%) after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two ASD patients during the procedure and in one PFO patient at 12th month of the follow-up (0.72%). CONCLUSION Transcatheter closure of PFOs and secundum-type ASDs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an efficacious and safe therapeutic option.
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Affiliation(s)
- Kudret Aytemir
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara
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14
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Saritas T, Kaya MG, Yin Lam Y, Erdem A, Akdeniz C, Demir F, Erol N, Demir H, Celebi A. A comparative study of Cardi-O-Fix septal occluder versus Amplatzer septal occluder in percutaneous closure of secundum atrial septal defects. Catheter Cardiovasc Interv 2013; 82:116-21. [DOI: 10.1002/ccd.23301] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/27/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Turkay Saritas
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology; Erciyes University School of Medicine; Kayseri; Turkey
| | - Yat Yin Lam
- Division of Cardiology; SH Ho Cardiovascular and Stroke Centre; Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; Hong Kong; SAR
| | - Abdullah Erdem
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Celal Akdeniz
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Fadli Demir
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Nurdan Erol
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Halil Demir
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Ahmet Celebi
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
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Masseli J, Bertog S, Stanczak L, Blankenbach K, Majunke N, Reiffenstein I, Renkhoff K, Lehn K, Wunderlich N, Sievert H. Transcatheter closure of multiple interatrial communications. Catheter Cardiovasc Interv 2012; 81:825-36. [PMID: 22907918 DOI: 10.1002/ccd.24329] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2011] [Accepted: 01/07/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We sought to examine acute and midterm results of closure of multiple interatrial communications with staged device deployment and to review the relevant literature. BACKGROUND Information about percutaneous methods of closure for multiple defects is limited. METHODS We treated 148 patients with multiple defects. Of these, 88 had a relevant left to right shunt ("LRS"), 52 had a presumed paradoxical embolism ("PPE"), five had both (LRS and PPE), and one patient, respectively, had migraine, decompression sickness, and a right to left shunt. After implantation of the first device, closure of additional septal defects was attempted only if indicated clinically. RESULTS Ninety-four patients received a single device and 53 more than one. In four patients, surgical defect closure followed. At the end of follow-up (FU; mean 4.5 ± 3.4 years), complete closure of all defects occurred in 67.6% (62.1% for LRS, 76.5% for PPE). Clinical success (small or trivial residual shunt) was achieved in 86.9% (83.9% for LRS, 90.2% for PPE). Complications included pericardial effusions in 2.7%, recurrent thromboembolic events in 4.8%, and new onset of atrial fibrillation in 10.1%. In a significant number of patients with multiple defects, after single device implantation, the likelihood of complete closure increased with FU time (26% complete closure at 1 month vs. 78% at 24 months). CONCLUSION Percutaneous closure of multiple interatrial communications is feasible and safe. Importantly, many residual defects close without further intervention at FU. Therefore, staged device delivery is an alternative to simultaneous device implantation, possibly requiring fewer and smaller second devices.
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Cansel M, Pekdemir H, Yağmur J, Tasolar H, Ermis N, Kurtoglu E, Acıkgoz N, Atas H, Ozdemir R. Early single clinical experience with the new Figulla ASD Occluder for transcatheter closure of atrial septal defect in adults. Arch Cardiovasc Dis 2011; 104:155-60. [DOI: 10.1016/j.acvd.2010.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 12/17/2010] [Accepted: 12/24/2010] [Indexed: 10/18/2022]
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Transcatheter closure of atrial septal defect in a patient with cor triatriatum sinister and atrial septal defect. Case Rep Cardiol 2011; 2011:740981. [PMID: 24826227 PMCID: PMC4007744 DOI: 10.1155/2011/740981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 07/26/2011] [Indexed: 11/22/2022] Open
Abstract
Cor triatriatum sinister is a rare congenital heart disease and rarely found in adults. The authors describe an asymptomatic 20-year old man presenting with heart murmur by check up. Transthoracic and transesophageal echocardiogram demonstrate atrial septal defect (ASD) secundum 26 mm and cor triatriatum sinister with 20 mm of fenestration. Transcatheter closure of ASD using Occlutech FigullaR device was successfully performed without complications. Echocardiogram post procedure demonstrate good position of device without obstruction of blood flow, no residual shunt and residual 12 mm of fenestration of cor triatriatum.
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Turkay S, Abdullah E, Celal A, Cenap Z, Nurdan E, Fadli D, Halil D, Ali AN, Ahmet C. Multiple transcatheter interventions in the same session in congenital cardiopathies. J Cardiovasc Dis Res 2010; 1:181-90. [PMID: 21264182 PMCID: PMC3023895 DOI: 10.4103/0975-3583.74261] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To investigate the methods of percutaneous transcatheter interventions for combined congenital heart disease and to evaluate its efficacy in children. MATERIALS AND METHODS Thirty cases (ages 3 days-13.5 years, body weight 3-35 kg) that underwent two multiple transcatheter interventions for combined or solitary congenital heart disease were retrospectively analyzed and presented. RESULTS A total of 61 transcatheter interventions were performed in 30 patients as combined procedures. In 29 patients, two different procedures were combined in the same session, in remaining one patient, combination of three interventions were performed in the same catheter session. Interventions performed in combined procedures were as follows: Coarctation balloon angioplasty in 12 cases, pulmonary balloon valvuloplasty in 10, PDA coil embolization in 10, aortic balloon valvuloplasty in 8, VSD closure in 5, ASD closure in 4, ductal stent implantation in 4, palliative pulmonary balloon valvuloplasty in 3, recanalization and angioplasty of the systemic-pulmonary shunt in 2, balloon atrial septostomy in one, aortic coarctation stent implantation in one, coil embolization of a pulmonary lobar sequestration in one and pulmonary valve perforation plus pulmonary balloon valvuloplasty in one were performed as first or second procedure. There was no mortality or major morbidity in relation to combined procedures. CONCLUSION Multiple transcatheter interventions in the same session are feasible, safe and effective with satisfactory good results. Second intervention may be performed as complementary procedure or independently to the first intervention.
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Affiliation(s)
- Saritas Turkay
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey
| | - Erdem Abdullah
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Akdeniz Celal
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Zeybek Cenap
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Erol Nurdan
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Demir Fadli
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Demir Halil
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Aydemir Numan Ali
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Cardiovascular Surgery, Istanbul, Turkey
| | - Celebi Ahmet
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center and Research Hospital, Pediatric Cardiology, Istanbul, Turkey
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PAC AYSENUR, POLAT TUGCINBORA, CETIN ILKER, OFLAZ MEHMETBURHAN, BALLI SEVKET. Figulla ASD Occluder versus Amplatzer Septal Occluder: A Comparative Study on Validation of a Novel Device for Percutaneous Closure of Atrial Septal Defects. J Interv Cardiol 2009; 22:489-95. [DOI: 10.1111/j.1540-8183.2009.00497.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Scordamaglio PR, Tedde ML, Minamoto H, Pedra CAC, Jatene FB. Tratamento endoscópico de fístulas da árvore traqueobrônquica com dispositivos para a correção de defeitos do septo interatrial: resultados preliminares. J Bras Pneumol 2009; 35:1156-60. [DOI: 10.1590/s1806-37132009001100015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 08/18/2009] [Indexed: 11/22/2022] Open
Abstract
As fístulas da árvore traqueobrônquica, sejam elas broncopleurais ou traqueoesofágicas, apresentam etiologia multifatorial, com incidência variável na literatura. Em geral, apresentam alta morbidade e mortalidade, com indicação formal de correção cirúrgica. Entretanto, a condição clínica dos pacientes muitas vezes não permite uma reintervenção cirúrgica de grande porte. Além disso, as tentativas de fechamento endoscópico raramente têm sucesso, principalmente em fístulas de grande diâmetro. Relatamos os casos de três pacientes submetidos ao fechamento endoscópico de fístulas, sendo duas maiores que 10 mm, com a aplicação de dispositivos oclusores utilizados na cardiologia intervencionista, de forma minimamente invasiva e com resultados iniciais positivos. Esses dados sinalizam que essa pode ser uma técnica promissora na resolução de fístulas da árvore traqueobrônquica.
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Tedde ML, Scordamaglio PR, Minamoto H, Figueiredo VR, Pedra CC, Jatene FB. Endobronchial closure of total bronchopleural fistula with Occlutech Figulla ASD N device. Ann Thorac Surg 2009; 88:e25-6. [PMID: 19699881 DOI: 10.1016/j.athoracsur.2009.06.069] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 05/27/2009] [Accepted: 06/09/2009] [Indexed: 11/17/2022]
Abstract
Bronchopleural fistula may be treated by medical, endoscopic, and surgical techniques, but large fistulas remain a challenge to be closed using endoscopic techniques. We describe the endoscopic closure of a bronchial total fistula with the Occlutech Figulla ASD N device (International Occlutech AB, Helsingborg, Sweden), originally designed for closure of an atrial septal defect. The procedure was conducted without general anesthesia or rigid bronchoscopy, bronchography, or radioscopy. An immediate reduction in the air leak was observed and also later on bronchoscopy, as the device was almost covered by granulation tissue. The endobronchial technique described seems to be safe and effective to manage large bronchopleural fistulas.
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Affiliation(s)
- Miguel L Tedde
- Thoracic Surgery Department, Heart Institute (InCor) and Hospital das Clinicas of São Paulo Medical School, São Paulo, Brazil
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Franke J, Steinberg DH, Sievert H. Interventional treatment of structural heart disease. MINIM INVASIV THER 2009; 18:110-21. [DOI: 10.1080/13645700902920486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Medrano López C, Guía Torrent JM, Rueda Núñez F, Moruno Tirado A. [Update on pediatric cardiology and congenital heart disease]. Rev Esp Cardiol 2009; 62 Suppl 1:39-52. [PMID: 19174049 DOI: 10.1016/s0300-8932(09)70040-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The fields of pediatric cardiology and congenital heart disease have experienced considerable progress in the last few years, with advances in new diagnostic and therapeutic techniques that can be applied at all stages of life from the fetus to the adult. This article reviews scientific publications in a number of areas that appeared between August 2007 and September 2008. In developed countries, congenital heart disease is becoming increasingly prevalent in nonpediatric patients, including pregnant women. Actions aimed at preventing coronary heart disease must be started early in infancy and should involve the promotion of a healthy diet and lifestyle. Recent developments in echocardiography include the introduction of three-dimensional echocardiography and of new techniques such as two-dimensional speckle tracking imaging, which can be used for both anatomical and functional investigations in patients with complex heart disease, including a univentricular heart. Progress has also occurred in fetal cardiology, with new data on prognosis and prognostic factors and developments in intrauterine interventions, though indications for these interventions have still to be established. Heart transplantation has become a routine procedure, supplemented in some cases by circulatory support devices. In catheter interventions, new devices have become available for the closure of atrial or ventricular septal defects and patent ductus arteriosus as well as for percutaneous pulmonary valve implantation. Surgery is also advancing, in some cases with hybrid techniques, particularly for the treatment of hypoplastic left heart syndrome. The article ends with a review of publications on cardiomyopathy, myocarditis and the treatment of bacterial endocarditis.
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Affiliation(s)
- Constancio Medrano López
- Cardiología Pediátrica, Hospital Infantil, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Off-Pump Atrial Septal Defect Closure Using the Universal Cardiac Introducer ®. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2009. [DOI: 10.1177/155698450900400105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Off-Pump Atrial Septal Defect Closure Using the Universal Cardiac Introducer®. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2009; 4:20-6. [DOI: 10.1097/imi.0b013e31819878f2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective Optimal atrial septal defect (ASD) closure should combine off-pump techniques with the effectiveness and versatility of open-heart techniques. We report our experience with off-pump ASD closure using the Universal Cardiac Introducer (UCI) in a porcine model. The goal was to create an ASD over the fossa ovale (FO) and position a patch over the ASD under ultrasound (US) imaging and augmented virtual reality guidance. Methods An US probe (tracked with a magnetic tracking system) was positioned into the esophagus (transesophageal echocardiographic probe) for real-time image-guidance. The right atrium (RA) of six pigs was exposed via a right lateral thoracotomy or medial sternotomy. The UCI was attached to the RA wall. A punching tool was introduced via the UCI, navigated and positioned, under US guidance, to create an ASD into the FO. A patch with its holder and a stapling device were introduced into the RA via the UCI. The patch was positioned on the ASD. Occlusion of the ASD was determined using US and Doppler imaging. Results The FO membrane was excised successfully in all animals. US image-guidance provided excellent visualization. The patch was positioned in all cases with complete occlusion of the ASD. The stapling device proved too bulky, impeding circumferential positioning. Conclusions Using the UCI, ASD closure was safe and feasible. US imaging, combined with virtual and augmented reality provided accurate navigating and positioning. This study also provided valuable information on the future design of anchoring devices for intracardiac procedures.
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