Catheter intervention for congenital heart diseases

Percutaneous closure of ostium secundum atrial septal defects (ASD) has been widely accepted and is becoming one of the standard treatments for this malformation. Among several devices, the Amplatzer Septal Occluder seems to provide the highest level of effectiveness and safety. Transcatheter ASD closure has been increasingly used in recent years with high success rates. The complete closure rate immediately after the procedure was 91.2%, and 97.1% 1-year after the procedure. However, some complications have been reported with the use of this device, such as arrhythmia, embolization, thrombus formation, pericardial effusion, atrioventricular block and cardiac erosion. Since the initial report by Cambier and colleagues, clinical experiences with transcatheter closure of the patent ductus arteriosus using Gianturco coils have increased rapidly. Cook detachable coil has the advantage that retrieval of coil is possible up to the moment of its release from the delivery wire. Thus, this detachable coil may have some technical benefits to occlusion of relatively larger diameter ductus arteriosus. There is also a 0.052 inch Gianturco coil. It contains more Dacron fibers, which contributes to high closure rate. Thus, it is used for larger patent ductus arteriosus and adult patients. Amplatzer Duct Occluder, which is not yet available in Japan, is reported to provide high success rate even in the large ductus.