Validation of a Prescreening Program for Transcatheter Atrial Septal Defect Closure

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Background:

• A significant percentage of patients referred for atrial septal defect (ASD) device closure had anatomy precluding the procedure, leading to workflow inefficiencies.
• This highlights the need for a structured prescreening process to optimize patient selection and resource allocation.

Purpose of the Study:

• To evaluate the effectiveness of a comprehensive prescreening protocol for pediatric patients undergoing atrial septal defect (ASD) device closure.
• To assess the impact of this protocol on procedural success rates, patient selection, and family counseling.

Main Methods:

• Retrospective study of pediatric patients undergoing ASD prescreening, including transthoracic echocardiogram and family consultation.
• Analysis of data from January 2011 to June 2013 at Children's Healthcare of Atlanta.
• Comparison of outcomes before and after implementation of the formal prescreening process.

Main Results:

• The prescreening protocol identified 29% of patients as unsuitable for device closure.
• Successful transcutaneous ASD device closure was achieved in 56.5% of screened patients.
• The incidence of unsuccessful ASD device closure decreased from 30% to 10.3% after implementing the prescreening program.

Conclusions:

• A comprehensive ASD prescreening evaluation and family consultation process improves the likelihood of successful device implantation.
• This protocol enhances patient selection, reduces procedural failures, and facilitates adequate preprocedural counseling.
• Implementing a prescreening program is crucial for optimizing the management of atrial septal defects requiring device closure.