Transcatheter Closure of Atrial Septal Defect

Self Expanding Platinum- Coated Nitinol Devices for Transcatheter Closure of Atrial Septal Defect: Prevention of Nickel Release

Pornthep Lertsapcharoen,MD, Apichai Khongphatthanayothin,MD, VidhavasLa-orkhun,MD, Kanyalak Vithessonthi , MD, Suphot Srimahachota , MD Journal of Invasive Cardiology 2009

Abstract

Coming soonA variety of nitinol containing devices for transcatheter closure of atrial septal defects (ASD) has been widely used. However, there is a concern about the release of nickel after nitinol device implantation. In this study platinum Coated nitinol device was braided from nanoplatinum coated nitinol wires in order to prevent nickel release. The Serum nickel levels before and after device implantation and 1 year results were evaluated.

Methods

Thirty one patients aged 4-59 years and weighing 13.7-90 kgs underwent transcatheter closure. Blood samples for serum nickel levels were taken before, 1 day, 1 week, 1 month and 3 months after implantation.

Results

Twenty nine (93.6%) patients had successful implantation. The mean ASD diameter was 19.7±4.8 mm (range10- 30mm).Procedure related complications included transient brachial plexus injury in 1 patient and transient dysrhythmia in 4 patients. All 29 patients had complete closure within 1 month after implantation. The mean serum level at baseline and 1 day , 1 week , 1 month and 3 months after implantation 0.65 ±0.28, 0.63±018, 0.67±0.34,0.55±01.6,0.52±0.14 ng/ml. respectively .There was no significant difference in serum nickel levels before and after implantation. There was no device related complication a t 1 year follow up.

Conclusion

Transcatheter ASD closure using a platinum coated nitinol device can be performed safely and successfully with good outcomes. Nano coating of platinum on nitinol wires can prevent nickel release following device implantation.