Percutaneous Closure of Atrial and Ventricular Septal Defects

  • Achille Gaspardone
  • Giulio G. Stefanini


Catheter occlusion of atrial septal defects has its roots in the 1950s, with early devices being implanted during closed-heart surgery without cardiopulmonary bypass. In 1974 King and Mills performed the first percutaneous atrial septal defects (ASD) closure in six dogs, by the use of a device introduced through a 23 F catheter. Two years later, the same device was successfully used in a 17-year-old girl. Since the mid-1980s an impressive development of materials and technique has prompted wide use of invasive procedures for the percutaneous closure of atrial and ventricular septal defects. The development of interventional techniques for closure of atrial and ventricular septal defects has completely changed the therapeutic approach to these diseases and has provided a new important tool for the treatment of these potentially dreadful clinical conditions, with a remarkable improvement in patients’ quality of life and prognosis. At present more than 80 % of patients with ASD can be treated percutaneously and an increasing number of patients with ventricular septal defects (VSD) are recommended to undergo percutaneous closure. Financial estimates indicate that the economic impact of this new treatment technology is to the order of $30 billion per year and it appears to be constantly increasing, as shown by the 58-fold increase in the use of this new therapeutic approach in the last 10 years.


Atrial Septal Defect Ventricular Septal Defect Ventricular Septal Defect Residual Shunt Atrial Septal Defect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Bedford DE, Papp C, Parkinson J (1941) Atrial septal defect. Br Heart J 3:37–38PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Dave KS, Pakrashi BC, Woolder GH et al (1973) Atrial septal defect in adults: clinical and hemodynamic results of surgery. Am J Cardiol 31:7–14PubMedCrossRefGoogle Scholar
  3. 3.
    Campbell M (1970) Natural history of atrial septal defects. Br Heart J 32:820–826PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Webb G (2001) Do patients over 40 years of age benefit from closure of an atrial septal defect? Heart 85:249–250PubMedCrossRefGoogle Scholar
  5. 5.
    Jemielity M, Dyszkiewicz W, Paluszkiewicz L, Perek B, Buczkowski P, Ponizynski A (2001) Do patients over 40 years of age benefit from surgical closure of an atrial septal defect? Heart 85:300–303PubMedCrossRefGoogle Scholar
  6. 6.
    Ward C (1994) Secundum atrial septal defect: routine surgical treatment is not of proven benefit. Br Heart J 71:219–223PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Connelly MS, Webb GD, Sommerville J et al (1998) Canadian consensus conference on adult congenital heart defects. Can J Cardiol 14:395–452PubMedGoogle Scholar
  8. 8.
    Murphy GJ, Gersh BJ, McGoon MD et al (1990) Long-term outcome after surgical repair of isolated atrial septal defect: follow-up at 27–32 years. N Engl J Med 323:1644–1650CrossRefGoogle Scholar
  9. 9.
    Shah D, Azar M, Oakley CM et al (1994) Natural history of secundum atrial septal defect in adults after medical or surgical treatment: a historical prospective study. Br Heart J 71:224–228PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Konstantinides S, Geibel A, Olschewski M et al (1995) A comparison of surgical and medical therapy for atrial septal defect in adults. N Engl J Med 333:469–473PubMedCrossRefGoogle Scholar
  11. 11.
    Meijboom F, Hess J, Szatmari A et al (1993) Long-term follow-up (9–20 years) after surgical closure of atrial septal defect at a young age. Am J Cardiol 72:1431–1434PubMedCrossRefGoogle Scholar
  12. 12.
    Gatzoulis MA, Freeman MA, Siu SC et al (1999) Atrial arrhythmias and surgical closure of atrial septal defect in adults. N Engl J Med 340:839–846PubMedCrossRefGoogle Scholar
  13. 13.
    Berger F, Vogel M, Kramer A et al (1999) Incidence of atrial flutter/fibrillation in adults with atrial septal defect before and after surgery. Ann Thorac Surg 68:75–78PubMedCrossRefGoogle Scholar
  14. 14.
    Minette MS, Sahn DJ (2006) Ventricular septal defects. Circulation 114:2190–2197PubMedCrossRefGoogle Scholar
  15. 15.
    Kidd L, Driscoll DJ, Gersony WM et al (1993) Second natural history study of congenital heart defects. Results of treatment of patients with ventricular septal defects. Circulation 87:138–151PubMedCrossRefGoogle Scholar
  16. 16.
    King TD, Mills NL (1974) Nonoperative closure of atrial septal defects. Surgery 75:383PubMedGoogle Scholar
  17. 17.
    King TD, Mills NL (1976) Secundum atrial septal defect: nonoperative closure during cardiac catheterization. JAMA 235:2506–2509PubMedCrossRefGoogle Scholar
  18. 18.
    Lock JE, Rome JJ, Davis R, Van Praagh S, Perry SB, Van Praagh R, Keane JF (1989) Transcatheter closure of atrial septal defects. Exp stud Circ 79:1091–1099CrossRefGoogle Scholar
  19. 19.
    Carminati M, Giusti S, Hausdorf G et al (2000) A European multicentric experience using the cardio seal and starflex double umbrella devices to close interatrial communications holes within oval fossa. Cardiol Young 10:519–526PubMedCrossRefGoogle Scholar
  20. 20.
    Zamora R, Sideris EB (2000) Results of transvenous occlusion of secundum atrial septal defects with the fourth generation buttoned device: comparison with first, second and third generation devices. International buttoned device trial group. J Am Coll Cardiol 36(2):583–592PubMedCrossRefGoogle Scholar
  21. 21.
    Sievert H, Babic UU, Hausdorf G, Schneider M, Hopp HW, Pfeiffer D, Pfisterer M, Friedli B, Urban P (1998) Transcatheter closure of atrial septal defect and patent foramen ovale with ASDOS device (a multi-institutional European trial). Am J Cardiol 82(11):1405–1413PubMedCrossRefGoogle Scholar
  22. 22.
    Rickers C, Hamm C, Stern H, Hofmann T, Franzen O, Schrader R, Sievert H, Schranz D, Michel-Behnke I, Vogt J, Kececioglu D, Sebening W, Eicken A, Meyer H, Matthies W, Kleber F, Hug J, Weil J (1998) Percutaneous closure of secundum atrial septal defect with a new self centering device (“angel wings”). Heart 80(5):517–521PubMedGoogle Scholar
  23. 23.
    Sharafuddin MJA, Gu X, Titus J et al (1997) Transvenous closure of secundum atrial septal defects: preliminary results with a new self-expanding nitilol prosthesis in swine model. Circulation 95:2162–2168PubMedCrossRefGoogle Scholar
  24. 24.
    Berger F, Ewert P, Bjornstad PG, Dahnert I, Krings G, Brilla-Austenat I, Vogel M, Lange PE (1999) Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer septal occluder. Cardiol Young 9(5):468–473PubMedGoogle Scholar
  25. 25.
    Sievert H, Wilson N, Trepels T et al (2001) Catheter closure of patent foramen ovale: experience with the new Helex occluder. Eur Heart J 22:42 (Abstract Supplement)Google Scholar
  26. 26.
    Wilkinson JL (1999) Can transcatheter closure of atrial septal defect be regarded as a “standard” procedure? Cardiol Young 9:458–461PubMedCrossRefGoogle Scholar
  27. 27.
    Lock JE, Block PC, McKay RG et al (1988) Transcatheter closure of ventricular septal defects. Circulation 78:361–368PubMedCrossRefGoogle Scholar
  28. 28.
    Thanopoulos BD, Tsaousis GS, Konstadopoulou GN et al (1999) Transcatheter closure of muscular ventricular septal defects with the Amplatzer ventricular septal defect occluder: initial clinical applications in children. J Am Coll Cardiol 33:1395–1399PubMedCrossRefGoogle Scholar
  29. 29.
    Hijazi ZM, Hakim F, Al-Fadley F et al (2000) Transcatheter closure of single muscular ventricular septal defects using the Amplatzer muscular VSD occluder: initial results and technical considerations. Cathet Cardiovasc Interv 49:167–172CrossRefGoogle Scholar
  30. 30.
    Arora R, Trehan V, Thakur AK et al (2004) Transcatheter closure of congenital muscular ventricular septal defect. J Interv Cardiol 17:109–115PubMedCrossRefGoogle Scholar
  31. 31.
    Fu YC, Bass J, Amin Z et al (2006) Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial. J Am Coll Cardiol 47:319–325PubMedCrossRefGoogle Scholar
  32. 32.
    Thanopoulos BV, Rigby ML, Karanasios E et al (2007) Transcatheter closure of perimembranous ventricular septal defects in infants and children using the Amplatzer perimembranous ventricular septal defect occluder. Am J Cardiol 99:984–989PubMedCrossRefGoogle Scholar
  33. 33.
    Holzer R, de Giovanni J, Walsh KP et al (2006) Transcatheter closure of perimembranous ventricular septal defects using the Amplatzer membranous VSD occluder: immediate and midterm results of an international registry. Cathet Cardiovasc Interv 68:620–628CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  1. 1.Department of Medicine, Division of CardiologyOspedale S. EugenioRomeItaly

Personalised recommendations