chapter  121
Catheter Closure of Intracardiac Shunts
Pages 10

Percutaneous closure of an atrial septal defect is firstline therapy in carefully selected patients and has been performed in more than 30,000 patients since first described in 1976.

DEVICES FOR ASD/PFO CLOSURE The features of nine commonly used devices for closure of the atrial septum are shown in Table 1; of these, the largest number of procedures has been performed with the CardioSEAL and Amplatzer systems. The CardioSEAL (and related STARFlex) device employs a double umbrella made of Dacron fabric supported by a metallic framework and in the case of the latter, a self-centering mechanism using nitinol micro-springs. The Amplatzer atrial septal occluder and patent foramen ovale device utilize a nitinol wire-frame mesh with enclosed polyester disks.The differences in device designs are readily apparent in Figure 1. Nonetheless, all devices share in common some type of metallic supporting structure with a fabric portion to occlude interatrial blood flow, and can be collapsed in some fashion to allow catheter deployment.