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Updated: Jul 5, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Efficiency of transcatheter closure of atrial septal defects in small and symptomatic children
Alain Fraisse1, Jean Losay, François Bourlon
1Cardiologie Pédiatrique, Département de Cardiologie, Hôpital La Timone, Marseille, France. alain.fraisse@ap-hm.fr
Insights
Transcatheter closure is effective for treating interatrial communication in children under 15kg. This procedure offers a safe and efficient first-line treatment, leading to symptom resolution and improved growth in most young patients.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Interatrial communication within the oval fossa (IAC-OVF) is a congenital heart defect.
- Transcatheter closure is an alternative to surgical repair for IAC-OVF.
- Efficacy in low-weight pediatric patients (<15kg) requires further evaluation.
Purpose of the Study:
- To assess the efficacy of transcatheter closure for IAC-OVF in children weighing 15 kilograms or less.
- To evaluate the safety and outcomes of this procedure in a pediatric population.
Main Methods:
- Multicentric French experience from 1997-2004.
- Included 35 children weighing ≤15 kg with successful transcatheter closure of IAC-OVF.
- Median follow-up of 2 years.
Main Results:
- All 35 patients became asymptomatic post-procedure, except one with bronchodysplasia.
- One patient required emergency surgery for a previously undiagnosed divided right atrium.
- Significant weight gain observed in patients followed for over 12 months.
Conclusions:
- Transcatheter closure of IAC-OVF is efficient and safe in children weighing 15 kg or less.
- It can be proposed as a first-line treatment for symptomatic pediatric patients.
- Children with growth retardation showed complete recovery within a year.
Objectives:
We report the multicentric French experience with transcatheter closure in children weighing 15 kilograms or less, with the aim of assessing the efficacy of the procedure in this age group.
Patients:
We included all children weighing 15 kilograms or less, and seen between January, 1997, and June, 2004, who had successful transcatheter closure of an interatrial communication within the oval fossa.
Results:
Transcatheter closure was performed in 35 patients weighing 15 kilograms or less, of whom 14 were male and 21 female. The procedures were undertaken in 8 different centres, the patients having a median age of 3 years, with a range from zero to 6.2 years, and a mean weight of 13 kilograms, with a range from 3.6 to 15 kilograms. All the patients were symptomatic, with associated cardiac malformations present in 4 cases, and extracardiac anomalies in 4 patients, including Down's syndrome in 3, and Adams Oliver syndrome in the other case. In 1 patient, emergency cardiac surgery was needed 24 h after the procedure to correct a previously undiagnosed divided right atrium. No other complication occurred. After a median follow-up of 2 years, with a range from 0.5 to 5.2 years, all the patients are asymptomatic, except for one long-standing patient with bronchodysplasia. In 1 other patient, a small residual bidirectional shunt was detected by echocardiography. No patient presented significant arrhythmia. In the patients followed-up for more than 12 months, we found a significant gain in weight gain.
Conclusion:
Transcatheter closure of an interatrial communication within the oval fossa is efficient in children weighing 15 kilograms or less, and can be proposed as a first line of treatment in symptomatic patients. Children with retarded growth tend to have complete recovery within one year of closure.
