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Current perspectives in percutaneous atrial septal defect closure devices.

Bissessor N - Med Devices (Auckl) (2015)

Bottom Line: Complications reported in the literature include thrombus formation, air embolization, device embolization, erosions, residual shunts, and nickel hypersensitivity.Modern devices have intermediate to long term data with outcomes that have been favorable.In this review, commonly used devices and deployment procedures are discussed together with a look at devices that show promise for the future.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, The Epworth Hospital, Melbourne, VIC, Australia ; Division of Interventional Cardiology, The Alfred Hospital, Melbourne, VIC, Australia ; Department of Clinical Science, Charles Sturt University Albury Campus, NSW, Australia ; Heart Foundation, Griffith University, QLD, Australia.

ABSTRACT
In the last decade, percutaneous atrial septal defect (ASD) closure has become the treatment of choice in most clinical presentations of ASD. Percutaneous ASD closure has established procedural safety through operator experience and improved device structure and deliverability. There have also been advances in diagnostic capabilities. Devices have evolved from large bulky meshes to repositionable, minimal residual mesh content that easily endothelializes and conforms well to surrounding structures. Biodegradable technology has been introduced and will be closely watched as a future option. The evolution of ASD closure device usage in the last four decades incorporates development that minimizes a wide range of serious side effects that have been reported over the years. Complications reported in the literature include thrombus formation, air embolization, device embolization, erosions, residual shunts, and nickel hypersensitivity. Modern devices have intermediate to long term data with outcomes that have been favorable. Devices are available in multiple sizes with improved delivery mechanisms to recapture, reposition, and safely close simple and complex ASDs amenable to percutaneous closure. In this review, commonly used devices and deployment procedures are discussed together with a look at devices that show promise for the future.

No MeSH data available.


Related in: MedlinePlus

Starflex CardioSEAL (NMT Medical, Boston, MA, USA).
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f5-mder-8-297: Starflex CardioSEAL (NMT Medical, Boston, MA, USA).

Mentions: In the last 25 years the original Clamshell device was upgraded to the CardioSEAL, which was then further upgraded to the Starflex (NMT Medical, Boston, MA, USA) (Figure 5). Device fractures were highest with the Clamshell, which was made of stainless steel, and Dacron. The CardioSEAL was made of a different metal alloy and less prone to fractures. The Starflex provided a framework from which the least amount of fractures was seen based on the flexibility of the metal hinge points. Starflex also offered improved positioning and deliverability. These device are no longer manufactured due to evolution in the industry in deliverability, device bulkiness, and complication risk. The CardioSEAL and Starflex device played a crucial role in establishing early safety, efficacy, and success in percutaneous ASD closure versus surgical closure.15 Use of these devices has been associated with a higher risk of left atrial thrombus, which can result in stroke, and was detected on TEE at 1 month in 7%–23% of implants.15


Current perspectives in percutaneous atrial septal defect closure devices.

Bissessor N - Med Devices (Auckl) (2015)

Starflex CardioSEAL (NMT Medical, Boston, MA, USA).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508077&req=5

f5-mder-8-297: Starflex CardioSEAL (NMT Medical, Boston, MA, USA).
Mentions: In the last 25 years the original Clamshell device was upgraded to the CardioSEAL, which was then further upgraded to the Starflex (NMT Medical, Boston, MA, USA) (Figure 5). Device fractures were highest with the Clamshell, which was made of stainless steel, and Dacron. The CardioSEAL was made of a different metal alloy and less prone to fractures. The Starflex provided a framework from which the least amount of fractures was seen based on the flexibility of the metal hinge points. Starflex also offered improved positioning and deliverability. These device are no longer manufactured due to evolution in the industry in deliverability, device bulkiness, and complication risk. The CardioSEAL and Starflex device played a crucial role in establishing early safety, efficacy, and success in percutaneous ASD closure versus surgical closure.15 Use of these devices has been associated with a higher risk of left atrial thrombus, which can result in stroke, and was detected on TEE at 1 month in 7%–23% of implants.15

Bottom Line: Complications reported in the literature include thrombus formation, air embolization, device embolization, erosions, residual shunts, and nickel hypersensitivity.Modern devices have intermediate to long term data with outcomes that have been favorable.In this review, commonly used devices and deployment procedures are discussed together with a look at devices that show promise for the future.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, The Epworth Hospital, Melbourne, VIC, Australia ; Division of Interventional Cardiology, The Alfred Hospital, Melbourne, VIC, Australia ; Department of Clinical Science, Charles Sturt University Albury Campus, NSW, Australia ; Heart Foundation, Griffith University, QLD, Australia.

ABSTRACT
In the last decade, percutaneous atrial septal defect (ASD) closure has become the treatment of choice in most clinical presentations of ASD. Percutaneous ASD closure has established procedural safety through operator experience and improved device structure and deliverability. There have also been advances in diagnostic capabilities. Devices have evolved from large bulky meshes to repositionable, minimal residual mesh content that easily endothelializes and conforms well to surrounding structures. Biodegradable technology has been introduced and will be closely watched as a future option. The evolution of ASD closure device usage in the last four decades incorporates development that minimizes a wide range of serious side effects that have been reported over the years. Complications reported in the literature include thrombus formation, air embolization, device embolization, erosions, residual shunts, and nickel hypersensitivity. Modern devices have intermediate to long term data with outcomes that have been favorable. Devices are available in multiple sizes with improved delivery mechanisms to recapture, reposition, and safely close simple and complex ASDs amenable to percutaneous closure. In this review, commonly used devices and deployment procedures are discussed together with a look at devices that show promise for the future.

No MeSH data available.


Related in: MedlinePlus