Echocardiographic characteristics of successful deployment of the Das AngelWings atrial septal defect closure device: initial multicenter experience in the United States

• Published in: The American journal of cardiology Vol. 83; no. 8; pp. 1236 - 1241
• Main Authors: Banerjee, Anirban, Bengur, A.Resai, Li, Jennifer S, Homans, David C, Toher, Cynthia, Bank, Alan J, Marx, Gerald R, Rhodes, Jonathan, Das, Gladwin S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.04.1999; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Birth defects; Blood Flow Velocity; Cardiac Surgical Procedures - methods; Cardiology; Child; Child, Preschool; Clinical trials; Diseases of the cardiovascular system; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Follow-Up Studies; Heart; Heart Septal Defects, Atrial - diagnostic imaging; Heart Septal Defects, Atrial - physiopathology; Heart Septal Defects, Atrial - surgery; Humans; Medical sciences; Medical supplies; Middle Aged; Prosthesis Design; Prosthesis Implantation - instrumentation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Therapy; Treatment Outcome; Ultrasonic imaging; United States; Sonography; Human; Echocardiography; Persistent fetal circulation; Device; Treatment efficiency; Instrumentation therapy; Cardiovascular disease; Exploration; Foramen ovale; Instrumental obliteration; Congenital disease; Persistence; Treatment; Heart disease; Ostium secundum
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(99)00065-X

The AngelWings device is a newer transcatheter device used for closure of secundum atrial septal defects (ASD) and patent foramen ovale (PFO), which consists of a self-centering, 2-disk system. Transesophageal echocardiography (TEE) plays a pivotal role in the deployment of the 2 disks of this device, on the appropriate sides of the atrial septum. The objective of this study is to describe the echocardiographic findings associated with successful deployment of the AngelWings device for closure of ASD and PFO. We evaluated the TEE studies of 70 patients enrolled in 4 United States centers, for closure of ASD and PFO with the AngelWings device. The TEE characteristics of successful and unsuccessful deployments were analyzed. Residual shunts across the atrial septum were assessed by TEE at the end of the procedure, 24 hours later by transthoracic echocardiography, and at 6 months by TEE. The deployment of the device was successful in 65 patients (93%). In the unsuccessful group, ASD size by TEE was larger (13.4 ± 3.1 vs 8.9 ± 4.7 mm, p <0.05). TEE was successful in identifying snagging of the device by intracardiac structures and prolapse of corners of the left or right atrial disk through the ASD, features that were difficult to identify by fluoroscopy. The echocardiographic characteristics outlined here are important guidelines for successful deployment of the AngelWings device.