Transcatheter closure with double Amplatzer septal occluder device in treatment of multiple atrial septal defects

Objective: To evaluate the clinical feasibility and effectiveness of transcatheter closure of multiple atrial septal defects (ASD) using double occluders. Methods: Seventeen patients underwent transcatheter closure of multiple ASD (2 or 3) with double devices under X-ray fluoroscopy and TTE. Electrocardiogram, X-ray chest radiography as well as echocardi-graphy were performed to evaluate the effectiveness after the procedure. Results: All patients had multiple ASD (12 with 2 defects and 5 with 3 defects). TTE during the procedures showed that the mean diameters of the larger, medium and smaller defects was (13.94±3.21)mm, (9.659±2.64)mm and (4.80±1.92)mm, respectively. Tanscatheter closure of multiple ASD succeeded in 16 patiets (16/17, 94.12%), 1 failed because the second defect was not suitable for intervention, and was cured by surgery, and totally 32 occluder devices were implanted and closed 37 defects. The mean diameters of the larger and the smaller occluders was (20.75±4.07)mm and (16.94±3.75)mm, respectively, larger than the value showed by TTE during procedures by (7.06±2.65)mm (larger defects) and (7.44±3.25)mm (medium defects). Immediately after the procedure, 3 patients had trivial shunt (2 patients with 3 defects), which disappeared 2, 3 days and 3 month later, respectively. No severe complication occurred, while femoral arteriovenous fistula was observed in 1 patient and disappeared 1 month later. The cardiothoracic ratio of X-ray chest radiography and the right ventricle internal diameter measured by echocardiography dropped during follow-up (all P<0.01). Conclusion: Transcatheter closure of multiple ASD with double devices is feasible, safe and effective.