Amplatzer devices

A variety of Amplatzer devices are applicable for LAA occlusion including the atrial and ventricular septal defect devices, the patent foramen ovale devices, the patent ductus arteriosus devices, and other arteriovenous fistulae devices. A special fabric-free LAA plug is currently under investigation (Rg. 2). 

The characteristic feature of all Amplatzer devices is the nitinol wire mesh. There are two possible methods of implantation. Either the device is placed entirely into the appendage or the distal disc is expanded in the neck and the proximal disc in the left atrium. The risk of residual shunting around the device is increased when it is totally inserted into the LAA with no part protruding into the atrium. The Amplatzer occluder series holds the widest spectrum of device sizes (4 to 40 mm), The device is attached to a delivery cable and can simply be opened or recollapsed into the delivery catheter. Release is by unscrewing the device after first testing stability with simple traction. 

Butera G, Carminati M, Chessa M, Delogu A, Drago M, Piazza L, Giamberti A and Frigiola A. CardioSEAL/STARflex versus amplatzer devices for percutaneous closure of small to moderate (up to 18 mm) atrial septal defects. Am Heart J 2004 9 148(3) 507-510. 

A residual VSD following surgical closure occurs in 10% to 40% of patients depending on its location (43). Selected patients are suitable for a transcatheter approach. Interventional closure of selected muscular VSD has been possible for some years using the Rashkind (44) and subsequent generation devices (Clamshell, CardioSEAL). Currently the Amplatzer muscular,... 

I. The Amplatzer occluder (Fig. 5) is probably the most widely used device in this indication. This double disc device... 

The use of detachable balloons to occlude the ISV was first described in 1981 [31]. Due to a lack of FDA approval for some of the devices and manufacturer related issues, the balloons have not always been readily available in the USA. From a technical standpoint, balloons were similar to coils in that they needed to be deployed above and below collateral connections. However, since the balloon occluded the vein completely, much like the Amplatz Vascular Plug, only one was necessary at any given site. As with coils, it was common for users of balloons to perform some type of sclerotherapy on the vein segments between balloons to decrease the development of collaterals. Balloons suffered from two major drawbacks that severely limited their more widespread acceptance. The first was cost. The other was that the size of the catheter required to deliver... 

Congenital heart disease (CHD) occurs in approximately 25 000 births per year in the United States. An atrial septal defect (ASD) is a spedfic form of CHD and is the third most common type of defect. Many people suffer from this disorder and in many cases it is only detected when the patient reaches middle age. Effective and efficient methods of repair are therefore needed to minimize the risks associated with traditional methods of ASD repair. In recent years, transcatheter closure methods for secundum type ASD have been developed. Currently the Amplatzer Septal Occluder, the Gore Helex Septal Occluder and the NMT Medical CardioSEAL-STARFiex Septal Occlusion systems have received FDA approval for ASD repair, the first of these only in 2001. This indicates that the use of these devices is still in its infancy. It can therefore be assumed that much more can be done to develop improved and more effective closure devices. It is the purpose of this chapter to describe ASDs and to outline the available technology with regard to transcatheter ASD repair devices. Hie discussion will centre around their construction and functioning, with special reference to their textile component. 

The Amplatzer Septal Occluder, produced by AGA Medical Corporation, Golden Valley, Minnesota was the first transcatheter device to be approved... 

Image of the Amplatzer Septal Occluder device used to repair secundum ASD. ... 

Amplatzer Septal Occluder Nitinol with polyester nonwoven Small to large Secundum ASD (maximum = larger than 20 mm) Self-centering device Stent-like... 

Garay F, Cao Q and Hijazi ZM. The Amplatzer septal occluder. In S. I D. Brecker,ed.Percaffl eoai Device Closure of the Atrial Septum.CmleA Kingdom Informa Heathcare 2006. 

US Products ASD Devices [Internet] [cited 2 April 2009]. Available from http //www.amplatzer.com/USProducts/ASDDevices/tabid/179/Default.aspx. 

Taaffe M, Fischer E, Baranowski A, Majunke N, Heinisch C, Leetz M, Hern R, Bayard Y, Btlscheck F, Reschke M, Hoffmann I, Wunderlich N, Wilson N and Sievert H. Comparison of three patent foramen ovale closure devices in a randomized trial (amplatzer versus CardioSEAL-STARflex versus helex occluder). Am J Cardiol 2008 5/1 101(9) 1353-1358. 

Amplatzer Septal Occluder, 543 schematic diagram, 544 structure, 545 Anaconda device, 662-3 stent graft, 455,663 AneuRx device, 651-3 Talent stent graft, 652,653 two-component AneuRx bifurcated AAA stent graft, 652 aneurysm, 437 risk estimation, 644 anterior cruciate ligament anatomy and structure, 591-5 anteromedial and posterolateral bundles, 593... 

Figure 20.8 Image of an Amplatz canine duct occluder (ACDO), which shows the fine nitinol wire mesh used as an embolic device to completely occlude patent ductus arteriosus (PDA) in dogs.

One of the most widely used and successful devices for percutaneous PFO closure is the Amplatzer PFO Occluder (St. Jude Medical Inc., St. Paul, MN), which is a device consisting of two nitinol discs that contain a polypropylene mesh (Meier, 2009). These types of devices have demonstrated complication rates of less than 5% and procedural success in 100% of cases (Taaffe et al., 2008). However, only 65% of the patients showed complete occlusion of the foramen ovale at 30 day follow-up. New generations of PFO closure devices could benefit from tissue scaffold technologies to allow rapid healing and tissue integration to achieve complete occlusion of PFOs at... 

Taaffe, M., Fischer, E., Baranowski, A., Majunke, N., Heinisch, C., Leetz, M., Hein, R., Bayard, Y., Buscheck, F., Reschke, M., Hoffmann, L, Wunderhch, N., Wilson, N., Sievert, H., 2008. Comparison of three patent foramen ovale closure devices in a randomized trial (Amplatzer versus CardioSEAL-STARflex versus Helex occluder). American Journal of Cardiology 101, 1353-1358. 

The original clamshell device was first introduced in 1989. It consisted of a double umbrella composed of four stainless steel arms covered with a polyester (Dacron ) meshwork. Each arm had a single springed hinge (see Fig. IS.S). - At the time of its introduction, double-umbrella devices were attractive because they offered the potential for minimal blood-flow pattern distortion due to their low profile. Additionally, since they possessed low alloy content, their corrosive potential was minimal. This device was deployed using an IIF sheath, which was smaller than the sheaths used by other devices at the time, but larger than those employed by the current Amplatzer Septal Occluder. ... 

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