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Atrial Septal Defect Treatment
Alternative to Open Surgery
A pediatric cardiologist with the University of Florida
Pediatric Cardiovascular Program at Wolfson
Children's Hospital - a program that has evolved into
one of the finest in the Southeast - started treating atrial
septal defect (ASD) with a new procedure that doesn't
require open-heart surgery in 2002. ASD is a hole between the
two upper chambers of the heart and is a birth defect.
On June 10, 2002, Jose Ettedgui, MD, performed the
first transcatheter closure of an atrial septal defect
using the "Amplatzer" Septal Occluder System on
3-year-old Jamie Raulerson. Jamie was diagnosed
with a heart murmur at birth, but wasn't diagnosed with
ASD until she had an echocardiogram at 18 months
old. "The doctor told me she might grow out of the
heart murmur, but she didn't," said Jamie's mother,
Renee Raulerson. "When they saw the hole in her
heart with the echocardiogram, they said that with the
size she had, only 10 percent close up, but the other 90
percent have open-heart surgery. They also told me
about this new procedure and said, hopefully, it would
work for her." The transcatheter procedure was a
complete success, and Jamie resumed her normal
activities quickly.
"Jamie had a good-size hole between the two upper
chambers of her heart, about 10mm in diameter," said
Dr. Ettedgui. "We often recommend repair in childhood
to prevent problems during the young and middle-age
adult years, such as heart failure, rhythm disturbances,
pulmonary hypertension and stroke, which can limit life
expectancy."
The procedure is performed under general anesthesia.
A catheter is inserted through a small needle puncture
in the groin. The doctor then navigates the catheter
through some of the body's largest veins to the right
side of the heart until it reaches the patient's heart,
visualizing with an angiogram. The catheter is
equipped with a balloon to stretch the hole, then the
balloon is deflated, and the "Amplatzer" Septal Occluder
is implanted.
Taking one to two hours, the procedure is much less
invasive than open-heart surgery. Unlike open-heart
surgery, which usually requires a hospital stay of four to
five days, most patients who have the new procedure
are able to go home the next morning and return to their
normal activities within two days.
"There is no cardiopulmonary bypass or blood
transfusion," said Dr. Ettedgui. "Also, the catheter
technique doesn't require a long recovery period and
there is no chest scar. The "Amplatzer" Septal Occluder
is implanted for life, so the child won't outgrow
it."
The University of Florida in Jacksonville
recruited Dr. Ettedgui to develop the interventional cardiology
program for children, a collaborative effort between the
University of Florida and Wolfson Children's Hospital.
Dr. Ettedgui serves as Chief of the Division of Pediatric
Cardiology/Jacksonville Pediatric Cardiovascular
Center.
Prior to moving to Jacksonville in April of 2002, Dr.
Ettedgui was at Children's Hospital of Pittsburgh,
where he had been performing this procedure since
1998 as part of a US multicenter study. The
transcatheter procedure was only recently approved by
the Food and Drug Administration and previously was
only available in Florida at children's hospitals in
Tampa and Miami.
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