Amplatzer Device Sizing Index (ADSI): Explanation and Clinical Context The Amplatzer Device Sizing Index (ADSI) is a validated tool to guide the selection of the optimal Amplatzer Septal Occluder (ASO) for closing Atrial Septal Defects (ASD). It is calculated as the ratio of the selected device diameter to the balloon-stretched ASD diameter.
An ADSI value between 1.2 and 1.5 is generally considered optimal, ensuring effective closure while minimizing risks. Values below 1.2 may indicate under-sizing, increasing the risk of residual shunt or device embolization. Values above 1.5 may indicate over-sizing, increasing the risk of atrial wall erosion or other complications.
This index should always be interpreted alongside morphological assessment of the septum and rim adequacy using echocardiography (TEE or ICE).
Reference:
Kammeraad J, et al. "Amplatzer Septal Occluder Sizing Index and Device Selection in ASD Closure: Clinical Outcomes and Safety." Catheter Cardiovasc Interv. 2004;61:430-436. doi:10.1002/ccd.20053