Closure of Atrial Septal Defect and Patent Foramen Ovale, the Simple Way
Keywords:atrial septal defect, patent foramen ovale, device closure, interatrial shunt
Catheter based closure of atrial septal defects was first described in 1974 but has only been used widely since the nineties. In 1992 the focus turned to closure of the patent foramen ovale which today is the most common atrial shunt closure. While the majority of centers advocate use of transesophageal or intracardiac echocardiographic guidance during implantation, fluoroscopy guided implantation is feasible, faster, cheaper, and more patient-friendly. Closure of a patent foramen ovale with an Amplatzer occluder (currently the preferred device) may take as little as 10 minutes with the possibility to return to full physical activity a couple of hours later. Complications are exceedingly rare ( < 1%). They include (about in the order of frequency) inguinal access problems, thrombus on the device, device embolization, cardiac perforation, erosion of the atrial wall by the device, or infection of the device. So far there are no reports of late complications although atrial fibrillation is one to be looked out for.
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