Occlutech products have been implanted in minimally invasive procedures in many thousands of patients globally. The close cooperation between the company and leading physicians all over the world who are actually performing the interventions is vital for Occlutech. Occlutech intends to be the most responsive and fastest acting company when it comes to servicing clients with innovation and additional versions of state of the art septal occluders.

One of the world's most experienced and influential operators, Prof. Ziyad Hijazi of Rush University in Chicago has extensive experience working with Occlutech’s range of ASD and PFO occluders.

By Lulu Abushahban, Rina Mittal, Ziyad M. Hijazi. Chest Hospital, Kuwait and Rush University, Chicago, IL

The case
A 4.5-year old female child was diagnosed to have secundum ASD that was diagnosed after a heart murmur was detected. She was totally asymptomatic. Her weight was 17 kg. Her cardiac examination was remarkable for a grade II/VI systolic ejection murmur heard at the left upper sternal border. Her chest radiograph demonstrated mild cardiomegaly with mild increase in pulmonary vascular markings. Her transthoracic echocardiogram (TTE) demonstrated the presence of two ASDs and an enlarged right ventricle. A 15 mm Occlutech Figulla ASD occluder was deployed under general endotracheal anesthesia with continuous transesophageal echocardiographic (TEE) guidance. The following morning, TTE revealed a good device position and no evidence of residual shunt. The patient was discharged home on 100 mg aspirin per day for 6 months.

Discussion
Device closure of secundum ASD has become routine practice. Until now, only the Amplatzer device was available to close large defects (>18 mm stretched diameter). Now the Occlutech Figulla N Occluder is an alternative device that can be used to close small, as well as large, defects. The major advantage of this device is the absence of the left atrial clamp, thus minimizing any chance for trauma and clot formation on the left atrial disc. The devices are available in sizes from 6-40 mm in 1.5 mm increments up to 12 mm and in 3 mm increments thereafter, thus, the number of devices that need to be stocked in the catheterization laboratory is only 15, thus reducing the cost spent on these devices for stocking.

This case illustrates the versatility of the Occlutech Figulla ASD Occluder N in closing multiple defects using one device. The rim of tissue between the two defects was small, thus enabling us to use one device to close both defects. The device handles very well and can be recaptured after deployment of both discs and thus can be repositioned quite easily.