Transcatheter closure of secundum atrial defect in small children.
Catheter Cardiovasc Interv
; 69(3): 447-52, 2007 Feb 15.
Article
em En
| MEDLINE
| ID: mdl-17191213
ABSTRACT
OBJECTIVE:
To assess safety and efficacy of transcatheter atrial septal defect (ASD) closure in small children.BACKGROUND:
Percutaneous closure of ASD is a well accepted alternative to surgery. Reported experience in small children remains, however, scarce.METHODS:
Fifty-two children underwent percutaneous ASD closure at a weight < or =15 kg, in four Belgian tertiary referral paediatric cardiology centers. Indication for treatment, device implantation rate, procedural details, complication rate, residual shunt on echocardiography, and impact of procedure on symptoms were retrospectively analyzed.RESULTS:
Mean age at procedure was 36 months (7-60), mean weight 13 kg (4.7-15). Associated cardiac lesions were seen in 21% of the patients and noncardiac in 32.7%. Most patients (69.2%) were symptomatic. Mean ASD size was 12 mm (range 5-20 mm). A device could be inserted in 49 patients (94%). No major complications occurred. Minor complications occurred in 8 patients (15.4%) including device embolization in 2, successfully treated with transcatheter retrieval and second device insertion. Mean follow-up reached 27 months (0.03-61.2). Residual shunt was absent, trivial, or small in 93% (n = 42) at latest follow-up. Clinical improvement was noted in 91.7% of the symptomatic patients. Minor complications were more frequent in the presence of large ASDs (>15 mm) but not in smaller babies (<10 kg).CONCLUSION:
Patients < or =15 kg requiring ASD closure form a special population with high incidence of associated anomalies and medical conditions. For this particular set of patients, percutaneous closure is a valid alternative. Asymptomatic or mildly symptomatic children should be treated at a later age.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cateterismo Cardíaco
/
Comunicação Interatrial
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Ano de publicação:
2007
Tipo de documento:
Article