Transcatheter treatment of coronary artery disease and atrial septal defect with sequential implantation of coronary stent and amplatzer septal occluder: Preliminary results

Eustaquio Onorato, Isidoro Pera, Alberto Lanzone, Vittorio Ambrosini, Paolo Rubino, Daniela Trabattoni, Mauro Pepi, Antonio L. Bartorelli

Research output: Contribution to journalArticle

Abstract

Coronary stent implantation had been established as a highly effective revascularization technique in patients with occlusive coronary artery disease. Transcatheter closure of atrial septal defects is becoming a definite alternative to surgery in properly selected patients. During a 19-month period, 6 patients (50% women; mean age, 58 ± 17 years; range, 32-73 years) of a consecutive series of 176 prospective multicenter registry patients undergoing transcatheter atrial septal defect closure were treated with sequential percutaneous coronary revascularization and Amplatzer septal occluder implantation. Indication for revascularization was stable angina in four patients and unstable angina in two. Indication for defect closure was significant left-to-right shunt with right ventricular enlargement. Defect diameter ranged from 13 to 20 mm by transesophageal echocardiography, and the stretched diameter measured 13 to 25 mm. Procedural success of both interventions was achieved in all cases without in-hospital complications. A total of seven stents were successfully implanted in five coronary vessels. No stent was used in one patient after successful PTCA. Immediate total closure of the defect was obtained in five patients. Trivial residual shunting, observed in one patient, disappeared at 24 hr. No adverse cardiac events, recurrence of anginal symptoms, or evidence of residual shunt were observed at clinical and echocardiographic follow-up, which ranged from 60 to 390 days (mean, 258 ± 150 days). These results suggest that sequential transcatheter therapy of coronary artery disease and atrial septal defect is safe and efficacious in selected patients.

Original languageEnglish
Pages (from-to)454-458
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume54
Issue number4
DOIs
Publication statusPublished - 2001

Keywords

  • Amplatzer septal occluder
  • Atrial septal defect
  • Coronary artery disease
  • Coronary stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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