Experience with the largest custom-made 48 mm fenestrated atrial septal occluder device and its 4-year follow-up
Atrial septal defects (ASDs) measuring <38 mm are referred for transcatheter closure. Availability of larger devices up to 46 mm extended the inclusion criteria. An elderly hypertensive male with a 44 mm secundum ASD and coexistent sick sinus syndrome and atrioventricular (AV) nodal block present...
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| Main Authors: | , |
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| Format: | Book |
| Published: |
Wolters Kluwer Medknow Publications,
2023-01-01T00:00:00Z.
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| Online Access: | Connect to this object online. |
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| Summary: | Atrial septal defects (ASDs) measuring <38 mm are referred for transcatheter closure. Availability of larger devices up to 46 mm extended the inclusion criteria. An elderly hypertensive male with a 44 mm secundum ASD and coexistent sick sinus syndrome and atrioventricular (AV) nodal block presented with syncope. Balloon interrogation unmasked restrictive left ventricular (LV) physiology. After AV synchronous pacing, balloon-assisted deployment of a custom fenestrated 48 mm Figulla septal occluder (Occlutech Inc., Schaffhausen, Switzerland) prevented a rise of LV end-diastolic pressures beyond 12 mmHg. Echocardiogram and computed tomography after 4 years confirmed a patent fenestration and favorable remodeling. This report of the clinical use of the largest ASD device demonstrated the feasibility of closure of extremely large defects despite a restrictive LV. |
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| Item Description: | 0974-2069 10.4103/apc.apc_126_22 |