(Circulation. 2001;104:711.)
© 2001 American Heart Association, Inc.
Basic Science Reports |
From the Department of Cardiology, Miami Childrens Hospital, Miami, Fla (E.M.Z.); the Department of Cardiology, Royal Hospital for Sick Children, Glasgow, Scotland (N.W.); W.L. Gore and Associates, Flagstaff, Ariz (W.C.); and the Department of Pediatric Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio (L.A.L.).
Correspondence to Evan M. Zahn, MD, Miami Childrens Hospital, Suite 104, 3200 SW 60th Court, Miami, FL 33155. E-mail emzmch{at}aol.com
Background A variety of transcatheter atrial septal defect (ASD) occluders are currently in use around the world. Although for the most part effective, all of these devices lack features that would be desirable in a "perfect" device. The Helex septal occluder is a new type of device designed to improve the results of transcatheter ASD closure. This study was designed to examine the effectiveness and safety of this occluder in an animal model.
Methods and Results The Helex was implanted into 24 dogs with surgically created ASDs. Procedural details focusing on deployment, removal, and early closure rates were examined. Follow-up consisted of sequential transesophageal echocardiography and fluoroscopy as well as epicardial contrast echocardiography and angiography at the time of death. Specimens were examined grossly and histologically, and devices were tested for metal fatigue. All animals had successful ASD closure. Implantation was uncomplicated (mean fluoroscopy time 11.7 minutes), and removal or repositioning was always possible. Closure rate as judged by transesophageal echocardiography was 88% initially and 100% at 2-week follow-up. Devices rapidly became infiltrated with connective tissue without inflammation and were endothelialized over time. There were no instances of thromboembolism. A single wire-frame fracture occurred secondary to a prototype delivery system malfunction.
Conclusions The Helex septal occluder proved safe and effective for ASD closure. Several advantages over currently available devices were evident in this model. Controlled prospective clinical trials are needed.
Key Words: heart septal defects catheterization pediatrics shunts
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