Here is what I found:
The most established device for ASD closure is the Amplatzer septal occluder. This is made from a double nitinol disk with a polyester coat.
Placement of septal occlusion device.
Access is gained via the right femoral vein using a 9F sheath. A 6F multipurpose catheter is mounted on a soft ‘J’ tipped guidewire and passed into the right atrium via the inferior vena cava. The wire is then passed across the atrial septum, guided by a combination of fluoroscopy at 20° left anterior oblique tilt and continuous observation of the TOE. This is generally straightforward with ASDs but can be more challenging with PFOs where a number of patient positioning manoeuvres and attempts may be required. If a PFO cannot be crossed, the procedure is abandoned. There is no indication for the formation of an iatrogenic atrial tract with a trans-septal needle.
After guidewire placement, a larger sheath is advanced. The septal closure device is then loaded onto the applicator and inserted into the sheath; this is commonly performed under water to allow very careful de-airing. The device in its sheath is then advanced into the left atrium, and the first disk deployed by slowly advancing the device out of the sheath. This is then pulled back against the left side of the inter-atrial septum before the second disk is deployed on the right side by pulling back further on the delivery sheath.
The TEE is then used to confirm correct placement and stability, often by vigorous movement of the device during observation (the ‘wiggle’ test). When stability has been confirmed and all cardiac structures have been examined, the device is deployed and the applicator removed. Reference: University of Oxford
Link to info: http://ceaccp.oxfordjournals.org/content/8/1/16.full
and Heart/Cardiovascular Disease. "She Stood in the Storm & When the Wind Did Not Blow Her Away, She Adjusted Her Sails."
Post Edited (stkitt) : 3/9/2014 12:13:56 PM (GMT-6)