Open Access

ARTICLE

Multi-Institutional US Experience of the Occlutech^© AFR Device in Congenital and Acquired Heart Disease

by Barry O’Callaghan¹, Jenny Zablah¹, Joseph Vettukattil², Daniel Levi^3,4, Morris Salem⁴, Allison Cabalka⁵, Jason Anderson⁶, Makram Ebeid⁶, Ryan Alexy⁷, Gareth J. Morgan^1,*

1 The Heart Institute, Children’s Hospital Colorado, Aurora, USA
2 Pediatric Cardiology, Helen DeVos Children’s Hospital, Grand Rapids, USA
3 Pediatric Cardiology, UCLA Health, Mattel Children’s Hospital, Los Angeles, USA
4 Pediatric Cardiology, UCLA Medical Centre, Los Angeles, USA
5 Pediatric Cardiology, Mayo Clinic, Rochester, USA
6 Pediatric Cardiology, University of Mississippi Medical Center, Jackson, USA
7 Pediatric Cardiology, Riley Hospital for Children at Indiana University Health, Indianapolis, USA

* Corresponding Author: Gareth J. Morgan. Email:

Congenital Heart Disease 2022, 17(1), 107-116. https://doi.org/10.32604/CHD.2022.018590

Received 04 August 2021; Accepted 09 September 2021; Issue published 26 October 2021

Abstract

Objectives: To detail the US multi-institutional experience with the Occlutech^© (Occlutech International AB, Helsingborg, Sweden) atrial flow regulator (AFR) in children and adults with acquired or congenital heart disease. Background: The creation of a long-term atrial communication is desirable in several cardiovascular disease phenotypes, most notably pulmonary arterial hypertension, disorders of increased left ventricular filling and increased cavopulmonary pressures in patients with a Fontan type circulation. Methods: Patients were identified for inclusion from the AFR device manufacturer database. Data was collected using a RedCap database following IRB approval. 8 weeks of follow up data was sought for each patient based on available data. Data was analyzed and summarized using SPSS. Results: We report the experience of 6 US centers in the implantation of AFR devices in 15 patients, across a wide age range, with different disease phenotypes and a variety of indications. Implantation was technically successful in all patients and improvement was noted in both clinical and hemodynamic parameters. There were no immediate or intermediate term complications reported. 3 patients died remote from implantation. Their deaths were not felt to be related to the AFR device or related procedural complications. Conclusion: Compassionate use of the AFR device in children and adults with congenital & acquired heart disease is technically feasible and produces beneficial short term hemodynamic and symptomatic improvement. Widespread uptake of this technique and treatment at specialist centers has the potential to provide significant benefits to a variety of complex patients with currently limited treatment options and indeterminate prognosis.

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