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Updated: Feb 9, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

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Transcatheter closure of large atrial septal defects (ASDs) in symptomatic children with device/weight ratio ≥1.5

Ali Houeijeh1, Sebastien Hascoët2, Hélène Bouvaist3

  • 1Pediatric Cardiology Department, Lille University Hospital, University Nord de France, Lille, France.

International Journal of Cardiology
|June 7, 2018
PubMed

Insights

Transcatheter closure of large atrial septal defects (ASDs) is feasible in small, symptomatic children. This procedure offers clinical improvement with a manageable complication rate in this high-risk group.

Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Atrial septal defects (ASDs) can cause symptoms in young children, especially with comorbidities.
  • Transcatheter closure of large ASDs in this population remains a subject of debate.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of transcatheter closure for large ASDs in children using a device-to-weight ratio of ≥1.5.
  • To assess the safety and efficacy of this approach in a high-risk pediatric population.

Main Methods:

  • Retrospective analysis of 40 pediatric patients undergoing percutaneous ASD closure with a device/weight ratio ≥1.5 across 6 European centers (2000-2016).
  • Procedures guided by transthoracic or transesophageal echocardiography, with analysis of device implantation success, complications, and clinical outcomes.

Main Results:

  • Successful device implantation in 97.5% of patients (39/40).
  • Severe complications occurred in 5% (e.g., complete atrioventricular block, vena cava thrombosis).
  • Pulmonary hypertension resolved in all patients, with no residual shunts, erosion, or embolization during follow-up.

Conclusions:

  • Percutaneous closure of large ASDs in small, symptomatic children is a viable option.
  • The procedure demonstrates clinical improvement and an acceptable complication profile in this challenging patient group.
Abstract

Keywords:
ASDAtrial septal defectsCatheterizationComplicationsCongenital heart diseasesPulmonary hypertension

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