{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:44:42Z","timestamp":1790912682607,"version":"4.1.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,5,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Transcatheter closure of secundum atrial septal defects (ASD) using the Amplatzer septal occluder is generally safe and effective, but erosion into the pericardial space or aorta has been described. Although the absolute risk of this complication is low, there has been no assessment of relative risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>All erosions reported to St. Jude Medical after ASD closure with an Amplatzer septal occluder (cases) were compared with controls (matched 2:1) who underwent ASD closure but did not develop an erosion. A total of 125 erosions were reported between 2002 and 2014, including 95 with an available echocardiogram. The median duration from implant to erosion was 14 days, but was &gt;1 year in 16 patients. Nine patients (all age \u226517 years) who died were more likely to have an oversized device, and to have erosion into the aorta, than survivors. Aortic or superior vena cava rim deficiencies were more common in cases than in controls. In addition, larger balloon-sized ASD diameter, Amplatzer septal occluder device size, and device size\u2013ASD diameter difference, and smaller weight:device size ratio were associated with erosion. On multivariable analysis, deficiency of any rim, device &gt;5 mm larger than ASD diameter, and weight:device size ratio were associated with erosion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In addition to aortic rim deficiency, which was almost universal among erosion cases, there were several relative risk factors for erosion after ASD closure with the Amplatzer septal occluder device. To understand the mechanisms of and absolute risk factors for this uncommon but serious complication, an adequately powered prospective study with thorough echocardiographic evaluation will be critical.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.115.019987","type":"journal-article","created":{"date-parts":[[2016,5,2]],"date-time":"2016-05-02T16:19:06Z","timestamp":1462205946000},"page":"1738-1746","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":149,"title":["Relative Risk Factors for Cardiac Erosion Following Transcatheter Closure of Atrial Septal Defects"],"prefix":"10.1161","volume":"133","author":[{"given":"Doff B.","family":"McElhinney","sequence":"first","affiliation":[{"name":"From Department of Cardiothoracic Surgery, Lucille Packard Children\u2019s Hospital, Stanford University, CA (D.B.M.); Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC (M.D.Q.); Our Lady\u2019s Hospital for Sick Children, Crumlin, Dublin, Ireland (D.K.); Division of Pediatric Cardiology, Banner Children\u2019s Specialists, Mesa, AZ (E.A.); and Department of Pediatrics, Children\u2019s Hospital of Georgia, Georgia Regents University, Augusta (Z.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Quartermain","sequence":"additional","affiliation":[{"name":"From Department of Cardiothoracic Surgery, Lucille Packard Children\u2019s Hospital, Stanford University, CA (D.B.M.); Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC (M.D.Q.); Our Lady\u2019s Hospital for Sick Children, Crumlin, Dublin, Ireland (D.K.); Division of Pediatric Cardiology, Banner Children\u2019s Specialists, Mesa, AZ (E.A.); and Department of Pediatrics, Children\u2019s Hospital of Georgia, Georgia Regents University, Augusta (Z.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Kenny","sequence":"additional","affiliation":[{"name":"From Department of Cardiothoracic Surgery, Lucille Packard Children\u2019s Hospital, Stanford University, CA (D.B.M.); Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC (M.D.Q.); Our Lady\u2019s Hospital for Sick Children, Crumlin, Dublin, Ireland (D.K.); Division of Pediatric Cardiology, Banner Children\u2019s Specialists, Mesa, AZ (E.A.); and Department of Pediatrics, Children\u2019s Hospital of Georgia, Georgia Regents University, Augusta (Z.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernerio","family":"Alboliras","sequence":"additional","affiliation":[{"name":"From Department of Cardiothoracic Surgery, Lucille Packard Children\u2019s Hospital, Stanford University, CA (D.B.M.); Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC (M.D.Q.); Our Lady\u2019s Hospital for Sick Children, Crumlin, Dublin, Ireland (D.K.); Division of Pediatric Cardiology, Banner Children\u2019s Specialists, Mesa, AZ (E.A.); and Department of Pediatrics, Children\u2019s Hospital of Georgia, Georgia Regents University, Augusta (Z.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahid","family":"Amin","sequence":"additional","affiliation":[{"name":"From Department of Cardiothoracic Surgery, Lucille Packard Children\u2019s Hospital, Stanford University, CA (D.B.M.); Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC (M.D.Q.); Our Lady\u2019s Hospital for Sick Children, Crumlin, Dublin, Ireland (D.K.); Division of Pediatric Cardiology, Banner Children\u2019s Specialists, Mesa, AZ (E.A.); and Department of Pediatrics, Children\u2019s Hospital of Georgia, Georgia Regents University, Augusta (Z.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01711-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2007.00107.x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1017\/S104795111100093X"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25684"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20211"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.12.072"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.02.032"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.06.013"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.12.021"},{"key":"e_1_3_3_12_2","first-page":"E139","article-title":"Late cardiac perforation following percutaneous atrial septal defect closure using the Solysafe device.","volume":"23","author":"Cabrera M","year":"2011","unstructured":"Cabrera M, Contreras A, Peirone A. Late cardiac perforation following percutaneous atrial septal defect closure using the Solysafe device. J Invasive Cardiol. 2011;23:E139\u2013E141.","journal-title":"J Invasive Cardiol"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24347"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24533"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24517"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25175"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24755"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.06.008"},{"key":"e_1_3_3_19_2","unstructured":"The U.S. Food and Drug Administration U.S. Department of Health and Human Services. Rare Serious Erosion Events Associated with St. Jude Septal Occluder (ASO). October 17 2013. http:\/\/www.fda.gov\/MedicalDevices\/Safety\/AlertsandNotices\/ucm371145.htm. Accessed September 8 2015."},{"key":"e_1_3_3_20_2","unstructured":"Circulatory System Devices Panel of the Medical Devices Advisory Committee. St. Jude Medical AMPLATZER\u00ae Atrial Septal Occluder Executive Summary; May 24 2012 Advisory Committee Briefing Materials. http:\/\/www.fda.gov\/downloads\/AdvisoryCommittees\/CommitteesMeetingMaterials\/MedicalDevices\/MedicalDevicesAdvisoryCommittee\/CirculatorySystemDevicesPanel\/UCM304944.pdf. 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