Türk Kardiyoloji Derneği Arşivi (Jul 2015)

Corrected balloon occlusive diameter to determine device size during percutaneous atrial septal defect closure

  • Şakir Arslan,
  • Göksel Çağırcı,
  • Nermin Bayar,
  • Erkan Köklü,
  • İsa Öner Yüksel,
  • Selçuk Küçükseymen,
  • Zehra Erkal,
  • Çağın Mustafa Üreyen,
  • Fuat Gündoğdu,
  • Yekta Gürlertop,
  • Mustafa Kemal Erol,
  • Naci Ceviz

DOI
https://doi.org/10.5543/tkda.2015.68217
Journal volume & issue
Vol. 43, no. 5
pp. 420 – 426

Abstract

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OBJECTIVE: The aim of this trial was to investigate the impact of corrected balloon occlusive diameter (cBOD) on successful performance of percutaneous atrial septal defect (ASD) closure. METHOD: The trial comprised 86 patients (60 female, 26 male; mean age 36.5+-14.3) on whom percutaneous ASD closure was performed. Patients were evaluated using transesophageal echocardiography (TEE). Relation of the defect to surrounding tissues and size of rims was also investigated. Balloon sizing was performed intraoperatively on all patients. Size of device was ascertained according to both durability of rims and whether or not they formed significant indentation, both of which determine cBOD. RESULTS: The ASD closure device was successfully implanted in 84 (97.5%) patients. Mean maximum defect size was 17.4+-5.9 mm, and mean color flow diameter was 16.8+-5.4 mm. Mean maximum defect size at the moment of loss of shunt flow was 18.4+-5.9mm with TEE, and 18.8+-6.1mm with fluoroscopy. Mean size of Amplatzer occluder device was 20.0+-6.5mm. Device embolization was observed in 2 patients. However, no death occurred during or after the procedure. CONCLUSION: Percutaneous secundum ASD closure is a safe and effective treatment modality in experienced centers. Utilizing corrected balloon occlusive diameter may be of benefit in deciding the size of ASD occluder device.

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