Factors related to successful transcatheter closure of atrial septal defects using the Amplatzer septal occluder.

The Amplatzer septal occluder (ASO) is used for transcatheter closure of atrial septal defects (ASDs). This study aimed to determine the factors influencing successful closure with the ASO. A retrospective analysis of 69 patients who underwent transcatheter ASD occlusion between 2003 and 2007 was performed. The ASO was successfully implanted during 67 (97%) of 69 procedures. A major adverse event occurred for 6 patients (9%), and 13 patients (19%) experienced a minor adverse event. The outcome for 53 cases (77%) was a composite clinical success. Patient age (p = 0.191) and consultant experience (p = 0.270) were not important factors in successful ASD occlusion. However, patient weight (p = 0.031), diameter of the defect (p = 0.030), device size (p = 0.044), aortic rim size (p = 0.002), and device/defect ratio (p < 0.001) all were significant factors. Complications were significantly more likely for patients whose device/defect ratio was <1.125 (loose) or > or = 1.333 (tight) (p < 0.001). The device/defect ratio may provide a clinically useful tool with the potential to predict patients likely to experience an adverse event as a result of transcatheter ASD occlusion. A larger sample would enable refinement of the device/defect ratio and provide a more robust prediction of success.