Comparison of the effectiveness and safety of single versus dual occluders for the closure of multiple atrial septal defects

The purpose of this study was to compare the effectiveness and safety of a single vs dual occluders in the treatment of multiple atrial septal defects (ASDs).We retrospectively reviewed the records of patients with multiple ASDs treated with single or dual Amplatzer septal occluders from January 2010 to March 2013. Data extracted from the medical records included patient demographic information, ASD sizes, distance between the defects, preprocedure and postprocedure echocardiographic parameters, and treatment-related complications. Treatment success was defined as the occluder stably fixed without shunting, and no effects to other heart structures.Sixty-four patients were included. There were no significant differences between the two groups with respect to age, weight, gender, larger ASD diameter, smaller ASD diameter, and echocardiographic parameters before treatment. Successful closure was achieved in all patients in the single-occluder group regardless of whether the distance between defects was ≥7 mm or7 mm, and in all patients in the dual-occluder group. Residual shunting after surgery and residual leakage after 1-year follow-up were significantly more common in the dual-occluder group compared with the single-occluder group (residual shunting: 31% vs. 8%, respectively; P=.02 and residual leakage: 19% vs. 2%, respectively; P=.04). No procedure-related complications occurred in either group.Single and dual occluders are both safe and effective for the repair of multiple ASDs; however, the risk of residual shunt is greater with dual occluders.