[Mid-term results of percutaneous closure of atrial septal defect in children]
J I Zabala Argüelles1, E García Fernández, E Maroto Alvaro
1Sección de Cardiología Pediátrica.Hospital General Universitario Gregorio Marañón, Madrid. zabalan@jet.es
Insights
Percutaneous closure of atrial septal defects using devices like Amplatzer is a safe and effective procedure. Medium-term follow-up shows high success rates with no complications in well-selected pediatric patients.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Interventional Cardiology
Context:
- Atrial septal defect (ASD) is a common congenital heart condition requiring intervention.
- Percutaneous closure offers a less invasive alternative to surgical repair.
- Evaluating medium-term outcomes is crucial for establishing the long-term efficacy of device closure.
Purpose:
- To assess the medium-term results of percutaneous closure for atrial septal defects in children.
- To evaluate the safety and efficacy of different closure devices (DAS-Angel Wings and Amplatzer).
Summary:
- Twenty-two children underwent percutaneous ASD closure using transesophageal echocardiography guidance.
- Implantation was successful in 19 patients, with minimal shunting resolving within one month.
- After a mean follow-up of 15 months, patients remained asymptomatic with no clinical or technical issues.
Impact:
- Percutaneous ASD closure demonstrates a high success rate and favorable safety profile in well-selected pediatric patients.
- This minimally invasive approach leads to rapid recovery and sustained asymptomatic status.
- The findings support percutaneous device closure as a primary treatment option for atrial septal defects.
Objective:
To evaluate the medium-term results of percutaneous closure of atrial septal defect.
Methods:
Twenty-two children (mean weight, 23 11kg; mean age, 5.7 2.4 years) underwent percutaneous atrial septal defect closure under general anesthesia. The procedure was monitored by transesophageal echocardiography. DAS-Angel Wings (n4) and the Amplatzer device (n18) were used.
Results:
Mean pulmonary artery pressure was 13 2.8mmHg, mean pulmonary vascular resistance was 1.50.5U/m2 and mean Qp/Qs flow ratio was 2.2 0.6. The mean diameter of the defects was 14.5 6.3mm by transesophageal echocardiography OmniPlane measurement and 15.95.3mm using balloon occlusion reference. A total of 31 devices were used: 4 Angel Wings and 27Amplatzer devices. Twelve Amplatzer devices were withdrawn through the introducer without complications, 5 due to a discrepancy in the size of the left auricle, 4 because they were too small to stabilize in the septum and 3 due to defective opening in the left auricle. In 19 patients implantation was successful. In 17 patients transthoracic color Doppler echocardiography carried out 24 hours after the procedure showed a minimal shunt which was no longer present 1 month later. The mean time of discharge was 38 12 hours after the procedure. After a mean follow up 15 6 months the patients remain asymptomatic with no clinical or technical problems.
Conclusion:
The success rate of percutaneous closure of atrial septal defects in well-selected patients was high and presented no complications.
