Atrial septal defect closure with the new Cardia Ultrasept II™ device with interposed Goretex patch: Mexican experience - has the perforation of Ivalon's membrane been solved?

Cardiol Young. 2018 May;28(5):709-714. doi: 10.1017/S1047951118000100. Epub 2018 Feb 27.

Abstract

Objectives: The objective of this study was to demonstrate the safety and feasibility of using the new Cardia Ultrasept II™ device with interposed Goretex patch referring to the perforation of polyvinyl alcohol membrane.

Background: Great advances have been made in the development of devices for closure of atrial septal defect. The Cardia Ultrasept II™ with interposed Goretex patch is the modified last generation of Cardia devices, having the advantage of a super-low profile within the atria and an integral locking delivery-retrieval mechanism that ensures safe deployment. In addition, with the interposition of the Goretex, it has been possible to abolish perforation of Ivalon's membrane as a complication.Methods and resultsPatients with ostium secundum atrial septal defect with surrounding rims with a minimum length of 5 mm and who underwent atrial septal defect closure with the new Ultrasept II™ with Goretex patch were included from two paediatric cardiac centres. Primary end point was to determine perforation of the Goretex membrane at follow-up; secondary end point included right ventricular diastolic diameter. In total, 30 patients underwent atrial septal defect closure at a median age of 6 (1-29) years. At follow-up for 6 (range, 1-15) months, freedom from perforations was 100%. A continuous decrease in right ventricular diastolic diameter was found with an initial median of 30 (25-49) mm and after catheterisation of 27.5 (18-33) mm, p=0.01, and Z-score of 2.6 (1.7-3.6) versus 1.9 (1-2.9) after procedure, p=0.01.

Conclusions: The new modified generation of the Ultrasept II™ device with interposed Goretex patch is a good alternative to achieve atrial septal defect closure safely and feasibly with no membrane perforation at follow-up.

Keywords: Atrial septal defect; CHD; Cardia Ultrasept II; Mexico.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Echocardiography, Doppler, Color
  • Echocardiography, Transesophageal
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Atrial / diagnosis
  • Heart Septal Defects, Atrial / epidemiology
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Incidence
  • Infant
  • Male
  • Mexico / epidemiology
  • Polytetrafluoroethylene*
  • Polyvinyls*
  • Postoperative Complications / epidemiology*
  • Prosthesis Design
  • Prosthesis Failure
  • Retrospective Studies
  • Septal Occluder Device*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Polyvinyls
  • ivalon sponge
  • Polytetrafluoroethylene