open access

Vol 21, No 3 (2014)
Original articles
Published online: 2014-06-09
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Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device

Mateusz Knop, Małgorzata Szkutnik, Roland Fiszer, Beata Białkowska, Jan Głowacki, Jacek Białkowski
DOI: 10.5603/CJ.a2013.0120
·
Cardiol J 2014;21(3):279-283.

open access

Vol 21, No 3 (2014)
Original articles
Published online: 2014-06-09

Abstract

Background: Transcatheter closure of atrial septal defect (ASD) in older children and adults is currently considered the first-choice therapeutic option. This approach remains challenging in younger children. The aim of the study was to evaluate feasibility, safety and midterm efficacy of percutaneous ASD closure in symptomatic infants ≤ 10 kg body weight in our institution.

Methods: There were 28 children up to 10 kg of body weight, who were qualified for transcatheter closure of ASD. All patients but one showed overload of right atrium and right ventricle. Mean weight of patients who underwent transcatheter closure was 9.2 ± 0.88 kg and age 1.59 ± 0.58 years, respectively. Transcatheter closure of ASD was conducted using Amplatzer occluders (ASO).

Results: The devices were implanted successfully in 26/28 patients (93%). In 2 (7%) children the device repeatedly straddled the septum in relatively big ASD and the procedure was abandoned. Mean ASD diameter in patients, who underwent transcatheter closure, was 9.08 ± 2.9 mm (transthoracic echocardiography) and mean implant size/weight ratio was 1.07 ± 0.31. In the child with right-left shunt through ASD normalization of saturation occurred. Mean fluoroscopy time was 4.16 min. In 3 children minor complications occurred: transient arrhythmias (n = 1), fever after procedure (n = 2). The follow-up time was 6.1 (range 1.2–11) years. At follow-up, clinical condition and/or growth improved in all patients except 4 children with coexisting comorbidity. No arrhythmia nor conduction disturbances were observed during follow-up.

Conclusions: In selected patients weighing less or equal to 10 kg, percutaneous closure of ASD is a safe and effective procedure.

Abstract

Background: Transcatheter closure of atrial septal defect (ASD) in older children and adults is currently considered the first-choice therapeutic option. This approach remains challenging in younger children. The aim of the study was to evaluate feasibility, safety and midterm efficacy of percutaneous ASD closure in symptomatic infants ≤ 10 kg body weight in our institution.

Methods: There were 28 children up to 10 kg of body weight, who were qualified for transcatheter closure of ASD. All patients but one showed overload of right atrium and right ventricle. Mean weight of patients who underwent transcatheter closure was 9.2 ± 0.88 kg and age 1.59 ± 0.58 years, respectively. Transcatheter closure of ASD was conducted using Amplatzer occluders (ASO).

Results: The devices were implanted successfully in 26/28 patients (93%). In 2 (7%) children the device repeatedly straddled the septum in relatively big ASD and the procedure was abandoned. Mean ASD diameter in patients, who underwent transcatheter closure, was 9.08 ± 2.9 mm (transthoracic echocardiography) and mean implant size/weight ratio was 1.07 ± 0.31. In the child with right-left shunt through ASD normalization of saturation occurred. Mean fluoroscopy time was 4.16 min. In 3 children minor complications occurred: transient arrhythmias (n = 1), fever after procedure (n = 2). The follow-up time was 6.1 (range 1.2–11) years. At follow-up, clinical condition and/or growth improved in all patients except 4 children with coexisting comorbidity. No arrhythmia nor conduction disturbances were observed during follow-up.

Conclusions: In selected patients weighing less or equal to 10 kg, percutaneous closure of ASD is a safe and effective procedure.

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Keywords

atrial septal defect, transcatheter closure, small children

About this article
Title

Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device

Journal

Cardiology Journal

Issue

Vol 21, No 3 (2014)

Pages

279-283

Published online

2014-06-09

DOI

10.5603/CJ.a2013.0120

Bibliographic record

Cardiol J 2014;21(3):279-283.

Keywords

atrial septal defect
transcatheter closure
small children

Authors

Mateusz Knop
Małgorzata Szkutnik
Roland Fiszer
Beata Białkowska
Jan Głowacki
Jacek Białkowski

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