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KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Abbreviations
- Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA)
Synonyms
- Septal occluder device
- Duct occluder device
Definitions
- Percutaneous, transcatheter occlusion of septal defect or vessel
- Invented by Dr. Kurt Amplatz, radiologist
- 4 varieties
- Septal (ASD) occluder
- FDA approved in 2001
- Designed to close atrial septal wall on each side of secundum defect
- Available in 4-38 mm sizes in USA
- Multifenestrated ASDs require cribriform occluder subtype
- Muscular VSD occluder
- Designed to close VSD on each side of defect
- 2 discs connected together by waist that corresponds to size of VSD
- Available in 4-18 mm waist sizes
- Duct occluder
- Designed to seal PDA
- Conical shape to conform to PDA
- Available in 5-16 mm diameters
- Vascular plug
- Used for embolization of peripheral arteries & veins
- Alternative to coils
- Septal (ASD) occluder
- Device made from nitinol mesh & polyester fabric, which provide rapid occlusion & substrate for tissue ingrowth
- Sizing balloon used to determine correct size device
- Requires transesophageal or intracardiac echocardiography as well as fluoroscopic imaging during procedure
- Can be repositioned & recaptured during placement
- Very high closure rates (> 95%)
- Indications for ASD closure device
- Ostium secundum ASD
- Clinical evidence of right ventricular (RV) volume overload
- Left-to-right shunt of 1.5:1 or greater, or RV chamber enlargement
- Contraindications
- Sepsis within 1 month prior to implantation
- Bleeding disorder or other contraindication to aspirin therapy after device placement
- Intracardiac thrombi
- Septal defect location < 5 mm from coronary sinus, atrioventricular valves, or pulmonary vein orifice
- Nickel allergy (as nitinol contains nickel)
- Follow-up
- Requires endocarditis prophylaxis & antiplatelet/anticoagulation therapy for 6 months post implantation
- Devices "conditional 6" to 3.0 Tesla magnet
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Selected References
- Jalal Z et al: Long-term complications after transcatheter atrial septal defect closure: a review of the medical literature. Can J Cardiol. ePub, 2016
- Behjati-Ardakani M et al: Long-term results of transcatheter closure of patent ductus arteriosus in adolescents and adults with Amplatzer duct occluder. N Am J Med Sci. 7(5):208-11, 2015
- Bissessor N: Current perspectives in percutaneous atrial septal defect closure devices. Med Devices (Auckl). 8:297-303, 2015
- Gossett JG et al: Growth of the atrial septum after Amplatzer device closure of atrial septal defects in young children. Catheter Cardiovasc Interv. 86(6):1041-7, 2015
- Saurav A et al: Comparison of percutaneous device closure versus surgical closure of peri-membranous ventricular septal defects: A systematic review and meta-analysis. Catheter Cardiovasc Interv. 86(6):1048-56, 2015
- Lee EY et al: Amplatzer atrial septal defect occluder for pediatric patients: radiographic appearance. Radiology. 233(2):471-6, 2004
- Butera G et al: Transcatheter closure of atrial septal defect in young children: results and follow-up. J Am Coll Cardiol. 42(2):241-5, 2003
- Kim JH et al: Radiologic findings of 2 commonly used cardiac septal occluders with clinical correlation. J Thorac Imaging. 18(3):183-9, 2003
- Chessa M et al: Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol. 39(6):1061-5, 2002
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Abbreviations
- Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA)
Synonyms
- Septal occluder device
- Duct occluder device
Definitions
- Percutaneous, transcatheter occlusion of septal defect or vessel
- Invented by Dr. Kurt Amplatz, radiologist
- 4 varieties
- Septal (ASD) occluder
- FDA approved in 2001
- Designed to close atrial septal wall on each side of secundum defect
- Available in 4-38 mm sizes in USA
- Multifenestrated ASDs require cribriform occluder subtype
- Muscular VSD occluder
- Designed to close VSD on each side of defect
- 2 discs connected together by waist that corresponds to size of VSD
- Available in 4-18 mm waist sizes
- Duct occluder
- Designed to seal PDA
- Conical shape to conform to PDA
- Available in 5-16 mm diameters
- Vascular plug
- Used for embolization of peripheral arteries & veins
- Alternative to coils
- Septal (ASD) occluder
- Device made from nitinol mesh & polyester fabric, which provide rapid occlusion & substrate for tissue ingrowth
- Sizing balloon used to determine correct size device
- Requires transesophageal or intracardiac echocardiography as well as fluoroscopic imaging during procedure
- Can be repositioned & recaptured during placement
- Very high closure rates (> 95%)
- Indications for ASD closure device
- Ostium secundum ASD
- Clinical evidence of right ventricular (RV) volume overload
- Left-to-right shunt of 1.5:1 or greater, or RV chamber enlargement
- Contraindications
- Sepsis within 1 month prior to implantation
- Bleeding disorder or other contraindication to aspirin therapy after device placement
- Intracardiac thrombi
- Septal defect location < 5 mm from coronary sinus, atrioventricular valves, or pulmonary vein orifice
- Nickel allergy (as nitinol contains nickel)
- Follow-up
- Requires endocarditis prophylaxis & antiplatelet/anticoagulation therapy for 6 months post implantation
- Devices "conditional 6" to 3.0 Tesla magnet
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Selected References
- Jalal Z et al: Long-term complications after transcatheter atrial septal defect closure: a review of the medical literature. Can J Cardiol. ePub, 2016
- Behjati-Ardakani M et al: Long-term results of transcatheter closure of patent ductus arteriosus in adolescents and adults with Amplatzer duct occluder. N Am J Med Sci. 7(5):208-11, 2015
- Bissessor N: Current perspectives in percutaneous atrial septal defect closure devices. Med Devices (Auckl). 8:297-303, 2015
- Gossett JG et al: Growth of the atrial septum after Amplatzer device closure of atrial septal defects in young children. Catheter Cardiovasc Interv. 86(6):1041-7, 2015
- Saurav A et al: Comparison of percutaneous device closure versus surgical closure of peri-membranous ventricular septal defects: A systematic review and meta-analysis. Catheter Cardiovasc Interv. 86(6):1048-56, 2015
- Lee EY et al: Amplatzer atrial septal defect occluder for pediatric patients: radiographic appearance. Radiology. 233(2):471-6, 2004
- Butera G et al: Transcatheter closure of atrial septal defect in young children: results and follow-up. J Am Coll Cardiol. 42(2):241-5, 2003
- Kim JH et al: Radiologic findings of 2 commonly used cardiac septal occluders with clinical correlation. J Thorac Imaging. 18(3):183-9, 2003
- Chessa M et al: Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol. 39(6):1061-5, 2002
