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To evaluate exposure to ionizing radiation during Amplatzer device occlusion, a prospective study was performed to measure surface entrance radiation dose by thermoluminescent dosimetry (TLD). Between June 1998 and April 1999, dosimetry was carried out on 12 patients with Amplatzer device occlusion of atrial septal defects (n = 10) or Fontan fenestration (n =) and 12 age-matched patients who underwent diagnostic catherization. TLD chips were placed at the posterior (PA) and right lateral (LA) chest wall as well as the thyroid (TH) and gonadal (GN) regions. The Amplatzer group had a median age of 6.4 yr (2.4-12.4 yr) and a median weight of 23.7 kg (15.6-28.9 kg), which were similar (p = NS) to those of the control group, who had a median age of 7.9 yr (3.3-16.2 yr) and a median weight of 29.9 kg (10.6-58.0 kg). Device placement was successful in 11 of 12 patients; one device was removed owing to partial obstruction of the right-upper pulmonary vein. Fluoroscopy times were also similar in the Amplatzer group (23.5 +/- 2.1 min) and the control group (16.4 +/- 3.1 min; P = NS). The measured surface entrance doses of the Amplatzer group was similar (p = NS) to those of the control group in all four regions: PA (4.96 +/- 1.88 vs. 6.07 +/- 2.16 cGy), LA (5.22 +/- 1.68 vs. 3.13 +/- 1.25 cGy), TH (0.92 +/- 0.14 vs. 0.69 +/- 0.09 cGy), and GN (0.20 +/- 0.00 vs. 0.22 +/- 0.01cGy). Fluoroscopy times and measured surface entrance doses of ionizing radiation in patients undergoing Amplatzer device occlusion are similar to those in patients undergoing routine diagnostic catheterization.

The early and 1-year follow-up of a single United States center using the Amplatzer atrial septal defect closure device is reported. Complete closure was documented in all patients by 1 year after device implantation.

The work of Goldblatt,1Page2and others has shown that hypertension may be produced experimentally in dogs and monkeys by effecting a relative ischemia of one or both kidneys. There are many ways in which clinical pathology might simulate the experimental methods of these workers. Blatt and Page3have studied a case of lymphosarcoma with hypertension apparently due to constriction of both renal arteries by the tumor mass. Ratliff,4Crabtree5and McIntyre6have reported hypertension in patients with unilateral, chronically infected kidney lesions. Of this group Goldblatt has said,7"It becomes probable that the hypertension associated with unilateral or bilateral pyelonephritis in children and adults occurs only in those cases in which there is associated vascular sclerosis or in which the inflammatory disease produces the same effect on renal circulation as does vascular disease." The reported cases of this type which have come to