This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Butera, G. Articles by Carminati, M. Search for Related Content PubMed PubMed Citation Articles by Butera, G. Articles by Carminati, M.

CLINICAL RESEARCH: INVASIVE AND INTERVENTIONAL CARDIOLOGY

Transcatheter closure of atrial septal defect in young children

Results and follow-up

^* Pediatric Cardiology Department, Istituto Policlinico San Donato, San Donato Milanese, Italy

Manuscript received December 18, 2002; revised manuscript received March 6, 2003, accepted April 3, 2003.

^* Reprint requests and correspondence: Dr. Gianfranco Butera, Pediatric Cardiology, Istituto Policlinico San Donato, Via Morandi, 30, 20097 San Donato Milanese, Milanese, Italy.
gianfra.but{at}lycos.com

OBJECTIVES: This study sought to analyze the safety, efficacy, and follow-up results of percutaneous closure of secundum atrial septal defect (ASD) in young children.

BACKGROUND: Results of ASD transcatheter closure in adults are widely reported but there are no large published series concerning young children.

METHODS: Between December 1996 and February 2002, 48 of 553 patients percutaneously treated at our institution were children age 5 years. Indications for closure were: elective closure in 32 patients; frequent respiratory infections in 8; failure to thrive in 2; liver transplantation in 5; and a fenestrated Fontan in 1. The procedure was carried out under general anesthesia with fluoroscopy and transesophageal control. Two different devices were used: 1) the CardioSEAL/StarFLEX (CS/SF) and 2) the Amplatzer septal occluder (ASO). Basal physical examinations and echocardiograms were performed prior to the procedure and at follow-ups (1, 6, and 12 months, and yearly thereafter).

RESULTS: The mean age at closure was 3.6 ± 1.3 years. A CS/SF was used in 10 subjects; an ASO was used in 38 patients. No deaths or immediate major complications occurred. The total occlusion rate was 87% at procedure, rising to 94% at discharge. The mean follow-up was 18 ± 14 months. No midterm major or minor complications occurred. The occlusion rate rose to 100% at 12 months of follow-up. Symptomatic patients improved significantly.

CONCLUSIONS: In the current era and in experienced hands, ASD closure can be performed safely and successfully, even in very young children.

Abbreviations and Acronyms   ASD   atrial septal defect   ASO   Amplatzer septal occluder   CS/SF   CardioSEAL/StarFLEX   Qp/Qs   pulmonary/systemic flow ratio   Rp/Rs   pulmonary/systemic resistance ratio

This article has been cited by other articles:

				H. H. Dave, M. Comber, T. Solinger, D. Bettex, A. Dodge-Khatami, and R. Pretre Mid-term results of right axillary incision for the repair of a wide range of congenital cardiac defects Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 864 - 870. [Abstract] [Full Text] [PDF]

				A. Hanslik, U. Pospisil, U. Salzer-Muhar, S. Greber-Platzer, and C. Male Predictors of Spontaneous Closure of Isolated Secundum Atrial Septal Defect in Children: A Longitudinal Study Pediatrics, October 1, 2006; 118(4): 1560 - 1565. [Abstract] [Full Text] [PDF]

				G Santoro, M Pascotto, S Caputo, F Cerrato, M Cappelli Bigazzi, M T Palladino, C Iacono, M Carrozza, M G Russo, and R Calabro Similar cardiac remodelling after transcatheter atrial septal defect closure in children and young adults Heart, July 1, 2006; 92(7): 958 - 962. [Abstract] [Full Text] [PDF]

				G Agnoletti, Y Boudjemline, P Ou, D Bonnet, and D Sidi Right to left shunt through interatrial septal defects in patients with congenital heart disease: results of interventional closure Heart, June 1, 2006; 92(6): 827 - 831. [Abstract] [Full Text] [PDF]

				V. L. Vida, J. Barnoya, M. O'Connell, J. Leon-Wyss, L. A. Larrazabal, and A. R. Castaneda Surgical Versus Percutaneous Occlusion of Ostium Secundum Atrial Septal Defects: Results and Cost-Effective Considerations in a Low-Income Country J. Am. Coll. Cardiol., January 17, 2006; 47(2): 326 - 331. [Abstract] [Full Text] [PDF]

				C. Schreiber, S. Bleiziffer, M. Kostolny, J. Horer, A. Eicken, K. Holper, P. Tassani-Prell, and R. Lange Minimally Invasive Midaxillary Muscle Sparing Thoracotomy for Atrial Septal Defect Closure in Prepubescent Patients Ann. Thorac. Surg., August 1, 2005; 80(2): 673 - 676. [Abstract] [Full Text] [PDF]

				R. Pretre, A. Kadner, H. Dave, A. Dodge-Khatami, D. Bettex, and F. Berger Right axillary incision: A cosmetically superior approach to repair a wide range of congenital cardiac defects J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 277 - 281. [Abstract] [Full Text] [PDF]

				W. T. Mahle, K. Lundine, K. R. Kanter, J. M. Forbess, P. Kirshbom, S. R. Tosone, and R. N. Vincent The short term effects of cardiopulmonary bypass on neurologic function in children and young adults Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 920 - 925. [Abstract] [Full Text] [PDF]

				E. Y. Lee, M. J. Siegel, C. M. Chu, F. R. Gutierrez, and H. W. Kort Amplatzer Atrial Septal Defect Occluder for Pediatric Patients: Radiographic Appearance Radiology, November 1, 2004; 233(2): 471 - 476. [Abstract] [Full Text] [PDF]

				R. A. Hopkins, A. A. Bert, B. Buchholz, K. Guarino, and M. Meyers Surgical patch closure of atrial septal defects Ann. Thorac. Surg., June 1, 2004; 77(6): 2144 - 2149. [Abstract] [Full Text] [PDF]