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. 2001 Apr;85(4):451–453. doi: 10.1136/heart.85.4.451

Assessment of the geometric profile of the Amplatzer and Cardioseal septal occluders by three dimensional echocardiography

P Acar 1, Z Saliba 1, P Bonhoeffer 1, D Sidi 1, J Kachaner 1
PMCID: PMC1729688  PMID: 11250975

Abstract

OBJECTIVE—To apply three dimensional echocardiography to describe the geometric profile of the Amplatzer and Cardioseal occluders after deployment for closure of atrial septal defect.
METHODS—20 patients (mean (SD) age, 14 (5) years) were enrolled for transcatheter closure of a secundum atrial septal defect with the Amplatzer occluder (10) or with the Cardioseal occluder (10). The two populations were matched for the stretched diameter of the defect (mean 18 (6) mm). The profile of the two occluders was examined.
RESULTS—Transoesophageal echocardiography did not show any residual shunts after Amplatzer occluder deployment, whereas three patients had a small residual leak after Cardioseal deployment. One patient had transient atrioventricular block with the Amplatzer device. The mean surface area of the Amplatzer occluder was 6.9 (2) cm2, and that of the Cardioseal device 5.4 (3) cm2 (p = 0.03). The mean volume of the Amplatzer occluder was 9.2 (1) cm3, while that of the Cardioseal occluder was 3.5 (1) cm3 (p < 0.0001). From the three dimensional views, the Cardioseal occluder looked like a flat square after deployment whereas the Amplatzer occluder took up a ball shape in the atrial cavity.
CONCLUSIONS—Three dimensional views by multiplane transoesophageal echocardiography allow a realistic in vivo description of atrial septal occluders. The Amplatzer occluder, with its high geometric profile, allows complete closure of large atrial septal defects but with some risk of mechanical complications. Use of the Cardioseal device, with its small surface coverage and high residual shunt rate, should be limited to transcatheter closure of a patent foramen ovale or small atrial septal defects.


Keywords: atrial septal occluder; three dimensional echocardiography

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Figure 1  .

Figure 1  

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Atrial septal occluders. The Cardioseal occluder (left) is a spring loaded Dacron double umbrella. The Amplatzer occluder (right) is a circular double disk frame with a conjoint waist made of nitinol windings.

Figure 2  .

Figure 2  

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En face three dimensional views from the left atrium. The disk of the Cardioseal occluder (left) looks like a square and the four arms are applied to the left atrial side of the septum. The disk of the Amplatzer occluder (right) has a ball shape in the left atrial cavity.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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