Percutaneous Closure of Atrial and Ventricular Septal Defects

Abstract

Catheter occlusion of atrial septal defects has its roots in the 1950s, with early devices being implanted during closed-heart surgery without cardiopulmonary bypass. In 1974 King and Mills performed the first percutaneous atrial septal defects (ASD) closure in six dogs, by the use of a device introduced through a 23 F catheter. Two years later, the same device was successfully used in a 17-year-old girl. Since the mid-1980s an impressive development of materials and technique has prompted wide use of invasive procedures for the percutaneous closure of atrial and ventricular septal defects. The development of interventional techniques for closure of atrial and ventricular septal defects has completely changed the therapeutic approach to these diseases and has provided a new important tool for the treatment of these potentially dreadful clinical conditions, with a remarkable improvement in patients’ quality of life and prognosis. At present more than 80 % of patients with ASD can be treated percutaneously and an increasing number of patients with ventricular septal defects (VSD) are recommended to undergo percutaneous closure. Financial estimates indicate that the economic impact of this new treatment technology is to the order of $30 billion per year and it appears to be constantly increasing, as shown by the 58-fold increase in the use of this new therapeutic approach in the last 10 years.