King's College London

Background
Percutaneous closure of atrial defects (ASD) has evolved as the treatment of choice for the majority of defects and patent oval foramens. The Gore Septal Occluder (GSO) is an innovative device consisting mostly of a folded thin GoreTex tube for use in the closure of septal defects.

Methods
Reviewed is the multicenter UK experience of the first 22 ASD occlusions with the GSOTM device. All implantations were performed by consultant operators experienced in ASD device closure. The inclusion criterion was the presence of a hemodynamically significant secundum ASD with a diameter of <18 mm. Procedural data and acute and mid-term closure rates were retrospectively matched to a cohort of patients having defect closure using the Amplatzer Septal OccluderTM (ASOTM).

Results
Acute and 3-month follow-up closure rates for the GSOTM were 100% and 100% vs. 100% and 100% closure with the ASOTM implants. The difference in paired procedure times was not statistically significant (56 min: GSOTM; 42 min: ASOTM device P = ns), nor was the paired difference in fluoroscopic screening times (12 min: GSOTM vs. 8.4 min: ASOTM, P = ns). One GSO device embolized immediately after deployment and was successfully retrieved at the same procedure. There were no other significant complications in either group.

Conclusions
The GSOTM implant can achieve comparable closure rates to the ASOTM in small to moderate atrial septal defects after 3 months. Longer fluoroscopy and procedure times are a drawback; however these should improve with familiarity with the implant and deployment system. The larger sheath size was not associated with increased complications in our cohort.