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Transcatheter Closure of Secundum Atrial Septal Defect with Buttoned" Device"

Published online May 15, 1995.
Transcatheter Closure of Secundum Atrial Septal Defect with Buttoned" Device"
Jong-Kyun Lee1, Seok Min Choi1, Jo Won Jung1, Jun Hee Sul1, Sung Kyu Lee1, Jin Yong Lee1, Hae Yong Lee2
1Division of Pediatric Cardiology, Yonsei Cardiovascular Center, Seoul, Korea
2Department of Pediatrics, Yonsei University, Wonju College of Medicine, Wonju, Korea
: Recently, non-operative transcatheter management of congenital heart defects h as increased due to their effectiveness and safety being acknowledged. In the case of secundu- m atrial septal defect(ASD), closing devices have been developed since 1974 and have been u sed clinically. The authors, having tried the "Buttoned" device which was developed in 1990 an d having succeeded in transcatheter closure of secundum ASD, are going to discuss the utilitie- s of this methods.
: Seven children of age 4.7 to 10.6 years was performed echocardiography and ca-rdiac catheterization and was diagnosed secumdum ASD. All were decided as the cases suitab-le for the implantation of the "Buttoned" device. The procedure were carried out under fluoros c opy and transesophageal echocardiography according the Rao and Sideris's protocol. The Qp: Qs ratio of these children were 1.8 to 2.5 and the balloon-stretched diameter of the delect was 14mm to 24mm. We, therefore used 25mm to 50mm sized "Buttoned" device.
: We succeeded the "Buttoned" device implantation in all of the 7 cases without any complications. In 4 of the cases, the defect was completely closed and the rest of the three ca-ses showed incomplete closure after the implantation of the devices. Of the three incomplete c losures, one was found to be completely closed after 1 month, and the other 2 cases are being follwed-up now for 7 months. There were no complications other than a grade I tricuspid regur-gitation in one case.
: Although the indications are limited in the transcatheter closure of the serund-um ASD, the "Buttoned" devices can be used safely and effectively without operative risks. "Buttoned" device can be a more useful device through making new improvements of it persisten- tly and long term follow-up results is required.
Key Words: \"Buttoned\" device의 크기는 25 -50mm를 사용하였다. 결 과 : 총 7예의 환아 모두에서 별문제없이 삽입에 성공하였고

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