Abstract
As a result of individual physicians' initiative, transcatheter closure of secundum atrial septal defects-a new procedure-was made available to patients in the Kaiser Permanente (KP) Southern California Region soon after the US Food and Drug Administration (FDA) approved use of the AMPLATZER Septal Occluder. This ingenious device and the procedure for its implantation are described along with results of implantation in our initial 51 pediatric and adult patients. These results are compared with other published results. The clinical implications of using this new procedure are major: Many pediatric and adult patients with atrial septal defects can now benefit from nonoperative closure of these defects. On the basis of these observations, we attest to the commitment of Permanente physicians to incorporate technical advances into medical practice and to assess KP's experience using the new technology.