Device therapy for atrial septal defects in a multicenter cohort: Acute outcomes and adverse events

Catheter Cardiovasc Interv. 2015 Feb 1;85(2):227-33. doi: 10.1002/ccd.25684. Epub 2014 Oct 13.

Device therapy for atrial septal defects in a multicenter cohort: Acute outcomes and adverse events.

El-Said H1Hegde SFoerster SHellenbrand WKreutzer JTrucco SMHolzer RBurch GMirani ANicolas RPorras DBergersen LMoore J.

Comment: In this study, El Said and colleagues seek to profile the procedural characteristics and safety of device closure of ASDs using a multi-institution collaborative registry, C3PO (The Congenital Cardiac Catheterization Project on Outcomes). In a 3 year period the authors identified 688 ASD closures (35 requiring more than one device) with 54 separate cases being aborted due to ASD characteristics or operator judgment; all defects were closed with either an Amplatzer Septal Occluder (ASO, 86%), Gore Helex Septal Occluder (GSO, 5%) or the StarFlex device (CSD, 9%). Patients undergoing attempted ASD device implant experienced an 11% rate of any adverse event, a 4.7% rate of a higher severity adverse event and no mortality. There were 3 erosions all associated with the ASO device, with all patients presenting within 32 hours of device placement and surviving the event to discharge. Other significant adverse events included heart block (15 cases, all resolved) and device embolization (10 cases, with 3 requiring surgical retrieval and defect closure). The authors state that their report confirms that a high percentage of defects are currently closed with the ASO, that the procedure has a high degree of success, and that it is generally safe.