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Updated: Jul 18, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter closure of secundum atrial defect in small children
L Cardenas1, J Panzer, D Boshoff
1Department of Paediatric Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Insights
Transcatheter closure of atrial septal defects (ASD) is safe and effective in children weighing 15 kg or less. This percutaneous approach offers a valid alternative to surgery for this unique patient group.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Percutaneous closure of atrial septal defects (ASD) is a recognized alternative to surgical repair.
- Limited data exists regarding the safety and efficacy of this procedure in very young or small children.
Purpose of the Study:
- To evaluate the safety and effectiveness of transcatheter ASD closure in children weighing 15 kg or less.
- To analyze procedural outcomes, complication rates, and long-term results in this specific pediatric population.
Main Methods:
- Retrospective analysis of 52 children weighing ≤15 kg who underwent transcatheter ASD closure across four Belgian centers.
- Data collected included indications, device implantation success, procedural details, complications, residual shunting, and symptom changes.
- Follow-up assessments included echocardiography and clinical evaluation.
Main Results:
- Successful device implantation was achieved in 94% of patients (n=49).
- No major complications were reported; minor complications occurred in 15.4% (n=8), including two cases of device embolization successfully managed.
- At a mean follow-up of 27 months, 93% had absent, trivial, or small residual shunts, and 91.7% of symptomatic patients improved clinically.
Conclusions:
- Transcatheter ASD closure is a safe and effective alternative for children ≤15 kg, who often present with associated anomalies.
- While effective in this group, the study suggests delaying treatment for asymptomatic or mildly symptomatic children until they are older.
- This approach provides a valuable option for managing ASDs in a challenging pediatric demographic.
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.
