1
|
Kao AS, Cardozo S. Three-Dimensional Cardiac Imaging: A Necessity to the Diagnosis and Treatment of Swiss-Cheese Atrial Septal Defect. Cureus 2023; 15:e40341. [PMID: 37456391 PMCID: PMC10338888 DOI: 10.7759/cureus.40341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Swiss-cheese atrial septal defect (ASD) is a malformation characterized by multi-fenestrated interatrial defects. Here, we describe a vignette of a 23-year-old man with Swiss-Cheese ASD characterized by two defects with areas of 0.74 cm2 and 0.44 cm2, complicated with an atrial septal aneurysm successfully repaired with a cribriform amplatzer septal occluder (ASO) via the percutaneous transcatheter approach. This case emphasizes the importance of attaining a clear view of three-dimensional structures for proper device selection and deployment in repair as additional structural defects such as concomitant aneurysms impose significant challenges.
Collapse
Affiliation(s)
- Andrew S Kao
- Internal Medicine, Wayne State University, Detroit, USA
| | | |
Collapse
|
2
|
Kumar V, Ward C, Justo R, Anderson B. The Gore Septal Occluder (GSO) for Multiple Indications in Children - An Intention to Treat Analysis. Heart Lung Circ 2021; 30:1578-1581. [PMID: 33903027 DOI: 10.1016/j.hlc.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/01/2021] [Accepted: 03/01/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the safety and efficacy of all uses of the Gore septal occluder (GSO) (WL Gore and Associates, Flagstaff, AZ, USA) in a tertiary children's hospital. BACKGROUND The GSO is widely used in atrial septal communication closure in the adult population. Usage in the paediatric population is expanding. Device design potentially confers some benefits in this population. METHODS Single centre retrospective data review over 6 years to July 2019 in a tertiary paediatric cardiac centre. All instances of intended GSO use were identified. Outcome measures were closure rates and procedural complications. RESULTS Fifty-four (54) patients with median age 7.9 years (3-17 years) and weight 26.5 kg (12.6-76 kg) underwent attempted GSO implantation. Indications were atrial septal defect (ASD) with volume loading (39); abolition of right to left shunt (8); stroke prevention (3) and Fontan fenestration (4). Successful GSO deployment in 46/50 (92%) of the ASD/PFO group and 100% of the Fontan group. Occlusion rate was assessed at 24 hours and at medians of 1.4 months (IQR 1.1 mo), 9 months (IQR 8.3 mo) and 25.4 months (IQR 28.1 mo). Complete occlusion documented at these points was 91%, 87%, 93% and 98% respectively. Major complications prevented GSO implantation in four patients. Two (2) patients had transient rhythm disorder. There was no incidence of erosion, further arrhythmia, venous access complications or death during follow-up. CONCLUSIONS The GSO can be safely deployed in both the atrial septum and Fontan fenestration with a low rate of complications. Trivial residual shunt is present in a number of cases early after deployment, although improves with time. Delivery sheath size was not a cause of significant complications in this patient cohort.
Collapse
Affiliation(s)
- Vivek Kumar
- Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Qld, Australia; Queensland Paediatric Cardiac Research Group, Brisbane, Qld, Australia
| | - Cameron Ward
- Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Qld, Australia; Queensland Paediatric Cardiac Research Group, Brisbane, Qld, Australia; University of Queensland, Brisbane, Qld, Australia
| | - Robert Justo
- Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Qld, Australia; Queensland Paediatric Cardiac Research Group, Brisbane, Qld, Australia; University of Queensland, Brisbane, Qld, Australia
| | - Benjamin Anderson
- Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Qld, Australia; Queensland Paediatric Cardiac Research Group, Brisbane, Qld, Australia; University of Queensland, Brisbane, Qld, Australia.
| |
Collapse
|
3
|
Outcomes of Device Closure of Atrial Septal Defects. CHILDREN-BASEL 2020; 7:children7090111. [PMID: 32854325 PMCID: PMC7552712 DOI: 10.3390/children7090111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023]
Abstract
Several devices have been designed and tried over the years to percutaneously close atrial septal defects (ASDs). Most of the devices were first experimented in animal models with subsequent clinical testing in human subjects. Some devices were discontinued or withdrawn from further clinical use for varied reasons and other devices received Food and Drug Administration (FDA) approval with consequent continued usage. The outcomes of both discontinued and currently used devices was presented in some detail. The results of device implantation are generally good when appropriate care and precautions are undertaken. At this time, Amplatzer Septal Occluder is most frequently utilized device for occlusion of secundum ASD around the world.
Collapse
|
4
|
Gordon BM, Abudayyeh I, Goble J, Collado NA, Paolillo J. Here today, gone tomorrow: Outcomes of residual leak following secundum atrial septal defect closure with the GORE CARDIOFORM Septal Occluder. Catheter Cardiovasc Interv 2020; 95:932-936. [PMID: 31876383 DOI: 10.1002/ccd.28666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/08/2019] [Accepted: 12/08/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the outcomes and potential predictors of residual leak after implantation of the GORE CARDIOFORM Septal Occluder (GSO) in secundum atrial septal defects (ASDs). BACKGROUND The non-self-centering design of the GSO could lead to residual leak at the edge of the device. Outcomes of residual leak are poorly understood. METHODS Retrospective, multicenter review of patients treated with the GSO for the pivotal and continued access study. Procedural, echocardiographic, and follow up data were reviewed. Multivariate analysis was performed to determine predictors of leak at implant and outcomes of these leaks. RESULTS There were 370 total ASD device closures with the GSO, 65 (17.56%) of which were found to have residual leak at implantation. Patients with residual leak had larger defects (10.33 ± 3.05 mm vs. 9.13 ± 2.89 mm, p = .006) and smaller aortic rims (4.87 ± 3.33 mm vs. 6.17 ± 3.78 mm, p = .019), as compared to those without leak. Larger devices were implanted (p = .008) and more devices per case (p = .007) were utilized in the residual leak cohort as compared to those without leak. Overall, among patients with residual leak, there was a significant decrease in leak size over 1 year, from 1.55 ± 0.75 mm to 0.25 ± 0.74 mm (p < .001), with the majority (87.6%) disappearing by 12-month follow-up. CONCLUSIONS Residual leak at implantation can be seen after ASD device closure with the GSO, more commonly in larger defects with smaller retroaortic rims. The vast majority of these leaks completely resolve by 1 year follow up.
Collapse
Affiliation(s)
- Brent M Gordon
- Division of Pediatric Cardiology, Loma Linda University Medical Center, Loma Linda, California
| | - Islam Abudayyeh
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California
| | | | - Nancy A Collado
- School of Public Health, Loma Linda University, Loma Linda, California
| | - Joseph Paolillo
- Division of Pediatric Cardiology, Sanger Heart & Vascular Institute/Levine Children's Hospital, Charlotte, North Carolina
| |
Collapse
|
5
|
Gillespie MJ, Javois AJ, Moore P, Forbes T, Paolillo JA. Use of the GORE® CARDIOFORM Septal Occluder for percutaneous closure of secundum atrial septal defects: Results of the multicenter U.S. IDE trial. Catheter Cardiovasc Interv 2020; 95:1296-1304. [DOI: 10.1002/ccd.28814] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 11/11/2022]
Affiliation(s)
| | - Alexander J. Javois
- Advocate Children's Hospital, Section of Pediatric Cardiology, University of Illinois Hospital Chicago Illinois
| | | | | | - Joseph A. Paolillo
- Sanger Heart & Vascular InstituteLevine Children's Hospital Charlotte North Carolina
| | | |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Jung SY, Choi JY. Transcatheter closure of atrial septal defect: principles and available devices. J Thorac Dis 2018; 10:S2909-S2922. [PMID: 30305951 DOI: 10.21037/jtd.2018.02.19] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
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. Most of currently available devices show excellent efficacy and comparable outcome with its own advantages and disadvantages. In addition to improvement of device properties and performance, there has been distinct improvement in procedural technique from numerous experiences of device closure of ASD. Nowadays there are well established principles regarding patient selection, pre-procedural evaluation, step-by-step details of procedure as well as post-procedural follow-up. However, an operator may encounter pitfalls in closing complex lesions such as large defect, rim deficiencies and multiple defects, so every operator has to be familiar with each available device, general principle as well as special issues for complex lesions.
Collapse
Affiliation(s)
- Se Yong Jung
- Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
| | - Jae Young Choi
- Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
| |
Collapse
|
8
|
Huang Y, Wong YS, Ng HCA, Boey FYC, Venkatraman S. Translation in cardiovascular stents and occluders: From biostable to fully degradable. Bioeng Transl Med 2017; 2:156-169. [PMID: 29313029 PMCID: PMC5675095 DOI: 10.1002/btm2.10066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/16/2017] [Accepted: 06/18/2017] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular disease is a major cause of morbidity and mortality, especially in developed countries. Most academic research efforts in cardiovascular disease management focus on pharmacological interventions, or are concerned with discovering new disease markers for diagnosis and monitoring. Nonpharmacological interventions with therapeutic devices, conversely, are driven largely by novel materials and device design. Examples of such devices include coronary stents, heart valves, ventricular assist devices, and occluders for septal defects. Until recently, development of such devices remained largely with medical device companies. We trace the materials evolution story in two of these devices (stents and occluders), while also highlighting academic contributions, including our own, to the evolution story. Specifically, it addresses not only our successes, but also the challenges facing the translatability of concepts generated via academic research.
Collapse
Affiliation(s)
- Yingying Huang
- School of Materials Science and Engineering Nanyang Technological University Singapore 639798 Singapore
| | - Yee Shan Wong
- School of Materials Science and Engineering Nanyang Technological University Singapore 639798 Singapore
| | - Herr Cheun Anthony Ng
- School of Materials Science and Engineering Nanyang Technological University Singapore 639798 Singapore
| | - Freddy Y C Boey
- School of Materials Science and Engineering Nanyang Technological University Singapore 639798 Singapore
| | - Subbu Venkatraman
- School of Materials Science and Engineering Nanyang Technological University Singapore 639798 Singapore
| |
Collapse
|
9
|
Hardt SE, Eicken A, Berger F, Schubert S, Carminati M, Butera G, Grohmann J, Höhn R, Nielsen-Kudsk JE, Hildick-Smith D, Settergren M, Thomson JD, Geis N, Søndergaard L. Closure of patent foramen ovale defects using GORE® CARDIOFORM septal occluder: Results from a prospective European multicenter study. Catheter Cardiovasc Interv 2017; 90:824-829. [PMID: 28296023 DOI: 10.1002/ccd.26993] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 01/15/2017] [Accepted: 01/28/2017] [Indexed: 01/24/2023]
Abstract
AIMS The GORE® CARDIOFORM Septal Occluder (GSO) is a novel device designed for rapid and effective closure of patent foramen ovale (PFO) which has distinctive features making it suitable for a broad spectrum of anatomical variations. We report the procedural and 6 months follow-up results of the first prospective, multicenter study using GSO. METHODS AND RESULTS This single-arm study included 150 subjects undergoing closure of PFO in 10 European centers. In 149 out of 150 patients implantation of a GSO device was successful. One patient had a different PFO-closure device implanted. Periprocedural complications were few including one patient with suspected transient ischemic attack, two access site bleedings, and one patient with AV-fistula. No device embolization occurred. During the 6-month follow-up period one patient had a transient asymptomatic thrombus on the device and four patients (2.6%) were diagnosed new onset paroxysmal atrial fibrillation, which were successfully treated. No thrombembolic events occurred. Closure was successful in 94.2% of subjects at discharge evaluation and 96.9% at 6 months follow-up. CONCLUSION This prospective, multicenter study adds to previous published data and suggests that GSO is a versatile device for PFO closure with high procedural and closure success rates and low complication rates through mid-term follow-up. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Stefan E Hardt
- Department of Cardiology, Angiology, and Pulmology, University of Heidelberg, Heidelberg, Germany.,Center for Cardiac and Circulatory Diseases, Bruchsal, Germany
| | - Andreas Eicken
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität, Munich, Germany
| | - Felix Berger
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Stephan Schubert
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Mario Carminati
- Department of Paediatric Cardiology and Cardiac Surgery and Adult Congenital Heart Disease, IRCCS Policlinico San Donato, Milan, 20097, Italy
| | - Gianfranco Butera
- Department of Paediatric Cardiology and Cardiac Surgery and Adult Congenital Heart Disease, IRCCS Policlinico San Donato, Milan, 20097, Italy
| | - Jochen Grohmann
- Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Freiburg, Germany
| | - Rene Höhn
- Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Freiburg, Germany
| | - Jens Erik Nielsen-Kudsk
- Department of Cardiology-Research, Institute of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus N, DK-8200, Denmark
| | | | - Magnus Settergren
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - John D Thomson
- Department of Congenital Cardiology, Leeds General Infirmary, Leeds, United Kingdom
| | - Nicolas Geis
- Department of Cardiology, Angiology, and Pulmology, University of Heidelberg, Heidelberg, Germany
| | - Lars Søndergaard
- The Heart Centre, Rigshospitalet University Hospital, Copenhagen, 2100, Denmark
| |
Collapse
|
10
|
Grohmann J, Wildberg C, Zartner P, Abu-Tair T, Tarusinov G, Kitzmüller E, Schmoor C, Stiller B, Kampmann C. Multicenter midterm follow-up results using the gore septal occluder for atrial septal defect closure in pediatric patients. Catheter Cardiovasc Interv 2016; 89:E226-E232. [DOI: 10.1002/ccd.26881] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/14/2016] [Accepted: 11/13/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Jochen Grohmann
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| | - Christian Wildberg
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| | - Peter Zartner
- Department of Cardiology; German Pediatric Heart Center; Sankt Augustin Germany
| | - Tariq Abu-Tair
- Department of Pediatric Cardiology and Congenital Heart Disease; University Children's Hospital, University Medicine Mainz; Mainz Germany
| | - Gleb Tarusinov
- Department for Pediatric Cardiology and Congenital Heart Disease; Heart Center Duisburg; Duisburg Germany
| | - Erwin Kitzmüller
- Department of Pediatric Cardiology; Medical University of Vienna; Vienna Austria
| | - Claudia Schmoor
- Faculty of Medicine; Clinical Trials Unit, Medical Center - University of Freiburg; Freiburg Germany
| | - Brigitte Stiller
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| | - Christoph Kampmann
- Department of Pediatric Cardiology and Congenital Heart Disease; University Children's Hospital, University Medicine Mainz; Mainz Germany
| |
Collapse
|
11
|
Abu-Tair T, Wiethoff CM, Kehr J, Kuroczynski W, Kampmann C. Transcatheter Closure of Atrial Septal Defects using the GORE(®) Septal Occluder in Children Less Than 10 kg of Body Weight. Pediatr Cardiol 2016; 37:778-83. [PMID: 26895499 DOI: 10.1007/s00246-016-1350-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/04/2016] [Indexed: 11/26/2022]
Abstract
The GORE(®) Septal Occluder (GSO) is a well-evaluated device for interventional ASD closure with closure rates comparable to the Amplatzer(®) Septal Occluder (ASO), but there are no published reports of its use in small children weighing less than 10 kg. This may be due to the necessity of a large-sized introducing sheath of at least 10 Fr and therefore the assumed risk of complications in vascular access. The GSO is an alternative option for interventional ASD closure in children weighing less than 10 kg. Fourteen infants and children with a median body weight 8900 g (range 6350-9650 g) underwent successful ASD closure using the GSO. The closure was performed under fluoroscopic and transthoracic echocardiographic guidance. Postprocedure, the vessels passed by the occluder and delivery catheter were examined by duplex sonography. The median ASD diameter was 11 mm (5-17 mm), and the median GSO size was 22.5 mm (15-30 mm), whereas the median ASO left disc size that would have been recommended was 25 mm (17-31 mm). All ASDs were successfully closed. During a median follow-up of 1.57 years (range 0.5-4.2), no complications like erosion, embolization, arrhythmias, or vascular injuries occurred. Although using a 10-Fr introducer sheath, no vascular complications were detected. Our data suggest that the small usable size as well as the soft and flexible design of the device allows successful use of the GSO in young children.
Collapse
Affiliation(s)
- Tariq Abu-Tair
- Department of Pediatric Cardiology and Congenital Heart Disease, University Children's Hospital, University Medicine Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Christiane M Wiethoff
- Department of Pediatric Cardiology and Congenital Heart Disease, University Children's Hospital, University Medicine Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Jascha Kehr
- Department of Pediatric Cardiology and Congenital Heart Disease, University Children's Hospital, University Medicine Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Wlodzimierz Kuroczynski
- Department of Pediatric Cardiology and Congenital Heart Disease, University Children's Hospital, University Medicine Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Christoph Kampmann
- Department of Pediatric Cardiology and Congenital Heart Disease, University Children's Hospital, University Medicine Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| |
Collapse
|
12
|
Latson LA. A snare in time-adding a safety mechanism to the Amplatzer Septal Occluder. Catheter Cardiovasc Interv 2016; 87:931-2. [DOI: 10.1002/ccd.26533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Larry A. Latson
- Clinical Professor of Pediatrics; Florida Atlantic University
| |
Collapse
|
13
|
Dittrich S, Sigler M, Priessmann H. Late complete atrioventricular block after closure of an atrial septal defect with a gore septal occluder (GSO™). Catheter Cardiovasc Interv 2015; 87:945-50. [PMID: 26354228 PMCID: PMC5049665 DOI: 10.1002/ccd.26154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/08/2015] [Accepted: 07/23/2015] [Indexed: 12/02/2022]
Abstract
Temporary intermittent complete heart block (CHB) occurred the day after interventional closure of an ASD with a 30 mm Gore Septal Occluder (GSO™) in a 2 years and 11‐month‐old female. CHB disappeared without further treatment and stable sinus rhythm recovered within 3 days. Only short episodes of 2nd degree AV‐block (Wenckebach periodicity) at rare intervals were documented in Holter‐monitors the following 2 months. Eleven months after device implantation the patient suffered from long lasting episodes of CHB. Surgical removal of the device resulted in incomplete recovery of AV‐conduction. Histopathological work‐up of the explanted GSO showed complete endothelialization of the device and regular scar formation. One year after surgery, the child had sinus rhythm during daytime but needed VVI‐pacing while sleeping. Young age, inferior localization of the defect, and use of a large device have been individual risk factors for CHB in this patient. Clinical course and histologic findings indicate that mechanical compression was the only cause for CHB. The cumulative number of reports of CHB after use of different ASD‐devices supports the recommendation to postpone the intervention in asymptomatic patients to preschool‐age. Early removal of a pushing device may increase the chance of complete recovery from CHB. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Sven Dittrich
- Department Pediatric Cardiology, Erlangen University Hospital, Erlangen, Germany
| | - Matthias Sigler
- Department Pediatric Cardiology and Intensive Care, Göttingen University Hospital, Göttingen, Germany
| | - Helga Priessmann
- Department Pediatric Cardiology, Erlangen University Hospital, Erlangen, Germany
| |
Collapse
|
14
|
Grohmann J, Höhn R, Fleck T, Schmoor C, Stiller B. Transcatheter closure of atrial septal defects in children and adolescents: Single-center experience with the GORE® septal occluder. Catheter Cardiovasc Interv 2014; 84:E51-7. [DOI: 10.1002/ccd.25494] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/27/2014] [Accepted: 03/12/2014] [Indexed: 11/05/2022]
Affiliation(s)
- J. Grohmann
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| | - R. Höhn
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| | - T. Fleck
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| | - C. Schmoor
- Clinical Trials Unit, Medical Center, University of Freiburg; Freiburg Germany
| | - B. Stiller
- Department of Congenital Heart Defects and Pediatric Cardiology; Heart Center, University of Freiburg; Freiburg Germany
| |
Collapse
|