Reversible complete atrioventricular block after percutaneous ASD device closure in a child <15 kg

Area of Science:

• Pediatric Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Transcatheter device closure is a common treatment for atrial septal defects (ASDs).
• Small children, particularly those weighing less than 15 kg, may face higher complication risks during ASD device closure.
• Complete atrioventricular heart block (CHB) is a rare but serious complication associated with this procedure in pediatric patients.

Observation:

• A case report details a 2-year-old girl weighing under 15 kg who underwent successful transcatheter closure of an ASD using an Amplatzer Septal Occluder.
• Twelve hours post-procedure, the patient developed complete atrioventricular heart block (CHB).

Findings:

• The CHB in this pediatric patient resolved completely by the fifth day following initiation of steroid treatment.
• This case highlights that CHB can occur even with an adequate postero-inferior margin in small children undergoing ASD device closure.

Implications:

• This case underscores the potential for rare complications like CHB in transcatheter ASD closure, even in technically suitable cases.
• Early recognition and prompt steroid treatment may be effective in managing CHB post-ASD device closure in pediatric populations.
• Further research into risk factors and management strategies for CHB in pediatric ASD device closure is warranted.