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Article: Transcatheter closure of right-to-left atrial shunts using Amplatzer septal occluder

TitleTranscatheter closure of right-to-left atrial shunts using Amplatzer septal occluder
Authors
KeywordsAmplatzer Septal Occluder
Atrial Shunts
Issue Date2005
PublisherMedcom Limited. The Journal's web site is located at http://www.hkjpaed.org/index.asp
Citation
Hong Kong Journal Of Paediatrics, 2005, v. 10 n. 4, p. 265-270+312 How to Cite?
Abstract
Purpose: We reviewed our experience in the closure of right-to-left atrial shunts using Amplatzer septal occluders. Methods: This is a retrospective review of 13 patients who underwent transcatheter closure of right-to-left atrial shunts for systemic hypoxaemia, at a median age of 8.0 years (range, 2.1 to 17.5), between April 1998 and March 2005. Results: The right-to-left shunts were associated with Fontan fenestrations (n=8), pulmonary atresia post right ventricular outflow tract reconstruction (RVOTR) (n=3), and critical pulmonary stenosis post-balloon valvoplasty (n=1) and RVOTR (n=1). The median procedural and fluoroscopic times were 140 minutes (range, 75 to 250) and 23 minutes (range, 13 to 55), respectively. A single occluder, with size ranging from six to 24 mm, was placed in 12 patients, while two (17 mm and 20 mm) occluders were deployed in one. There were no procedural failures or immediate complications. Systemic arterial oxygen saturation increased from 81.0±9.0% to 94.9±2.4% (p=0.008), while the mean right atrial pressure increased slightly from 11.8±3.6 to 13.5±3.5 mmHg (p=0.013) after the procedure. The median follow-up duration was 63 months (range, 7 to 75). One patient developed transient ischaemic attacks within the first week of device implantation. Follow-up echocardiography revealed no leak through the implanted devices, although residual shunts through additional small atrial communications were noted in four patients. Conclusion: Amplatzer septal occluder effectively eliminates right-to-left atrial shunts with significant improvement in systemic arterial oxygenation. Serial monitoring for systemic venous congestion is, however, warranted.
Persistent Identifierhttp://hdl.handle.net/10722/170357
ISSN
2013 Impact Factor: 0.106
2013 SCImago Journal Rankings: 0.126
References

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorChau, AKTen_US
dc.contributor.authorYung, TCen_US
dc.contributor.authorLun, KSen_US
dc.date.accessioned2012-10-30T06:07:45Z-
dc.date.available2012-10-30T06:07:45Z-
dc.date.issued2005en_US
dc.identifier.citationHong Kong Journal Of Paediatrics, 2005, v. 10 n. 4, p. 265-270+312en_US
dc.identifier.issn1013-9923en_US
dc.identifier.urihttp://hdl.handle.net/10722/170357-
dc.description.abstractPurpose: We reviewed our experience in the closure of right-to-left atrial shunts using Amplatzer septal occluders. Methods: This is a retrospective review of 13 patients who underwent transcatheter closure of right-to-left atrial shunts for systemic hypoxaemia, at a median age of 8.0 years (range, 2.1 to 17.5), between April 1998 and March 2005. Results: The right-to-left shunts were associated with Fontan fenestrations (n=8), pulmonary atresia post right ventricular outflow tract reconstruction (RVOTR) (n=3), and critical pulmonary stenosis post-balloon valvoplasty (n=1) and RVOTR (n=1). The median procedural and fluoroscopic times were 140 minutes (range, 75 to 250) and 23 minutes (range, 13 to 55), respectively. A single occluder, with size ranging from six to 24 mm, was placed in 12 patients, while two (17 mm and 20 mm) occluders were deployed in one. There were no procedural failures or immediate complications. Systemic arterial oxygen saturation increased from 81.0±9.0% to 94.9±2.4% (p=0.008), while the mean right atrial pressure increased slightly from 11.8±3.6 to 13.5±3.5 mmHg (p=0.013) after the procedure. The median follow-up duration was 63 months (range, 7 to 75). One patient developed transient ischaemic attacks within the first week of device implantation. Follow-up echocardiography revealed no leak through the implanted devices, although residual shunts through additional small atrial communications were noted in four patients. Conclusion: Amplatzer septal occluder effectively eliminates right-to-left atrial shunts with significant improvement in systemic arterial oxygenation. Serial monitoring for systemic venous congestion is, however, warranted.en_US
dc.languageengen_US
dc.publisherMedcom Limited. The Journal's web site is located at http://www.hkjpaed.org/index.aspen_US
dc.relation.ispartofHong Kong Journal of Paediatricsen_US
dc.subjectAmplatzer Septal Occluderen_US
dc.subjectAtrial Shuntsen_US
dc.titleTranscatheter closure of right-to-left atrial shunts using Amplatzer septal occluderen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-27644599818en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27644599818&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume10en_US
dc.identifier.issue4en_US
dc.identifier.spage265en_US
dc.identifier.epage270+312en_US
dc.publisher.placeHong Kongen_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.scopusauthoridChau, AKT=35787094400en_US
dc.identifier.scopusauthoridYung, TC=9132842300en_US
dc.identifier.scopusauthoridLun, KS=8363663600en_US

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