Transcatheter Closure of Atrial Septal Defects with the STARFlex Device: Early Results and Follow‐Up

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Abstract
Background: The STARFlex (SF) device is a CardioSEAL (CS) double‐umbrella device that has been modified by the addition of a self‐centering mechanism comprised of nitinol springs connected between the two umbrellas and a flexible core wire with a pin‐pivoting connection. This paper compares the results of atrial septal defect (ASD) closure with CardioSEAL and STARFlex devices. Patients and Methods: Between December 1996 and March 2000, 117 patients underwent ASD closure with CardioSEAL (n = 79) and STARFlex (n = 38). The mean age (17 years), weight (49 kg), and ASD size (15 mm) were similar in the two groups. The procedures were performed under general anesthesia with both fluoroscopic and transesophageal echocardiographic monitoring. Immediate Results: The devices were successfully implanted in all patients. Ten patients had multiple ASDs. A single device was used in four patients (CardioSEAL in three, STARFlex in one), while a simultaneous placement of two CardioSEAL (one patient) or two STARFlex (five patients) were performed in six patients. The results are summarized as follows: