Clinical Use of the Amplatzer Device in the Management of Intracardiac Defects: A Single-Center Experience.

Abstract

Device therapy is a viable alternative to open heart surgery in the management of intracardiac defects. The Amplatzer septal occluder (ASO) is one such device that has been adapted to close a wide variety of cardiac defects with few complications and a high success rate. This is a retrospective review of all the patients who received the ASO between 2012 and 2016 at the University of Kentucky. In total, 169 patients underwent percutaneous closure of a septal defect with Amplatzer during the timeframe studied, and of those, 91% received the device for an atrial septal defect or patent foramen ovale. Patients presented with stroke, transient ischemic attack, migraine, dyspnea or other symptoms and were diagnosed by transesophageal echocardiography and cardiac catheterization. All Amplatzer devices achieved successful closure without requiring a second procedure. Four patients sustained complications of the procedure, with two experiencing tamponade, one with hematoma, and one with cellulitis. The Amplatzer device was not directly implicated in the three fatalities that occurred within 30 days of the septal occlusion procedure. The ASO has performed very well at our institution and we expect it to serve additional functions as the field of transcatheter cardiology develops.