| Transcatheter Closure of Secundum Atrial Septal Defect with Buttoned" Device" |
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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 |
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| Abstract |
Purpose
: 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.
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.
Results
: 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.
Conclusion
: 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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