Abstract | OBJECTIVES: This study sought to analyze the safety, efficacy, and follow-up results of percutaneous closure of secundum atrial septal defect (ASD) in young children. BACKGROUND: Results of ASD transcatheter closure in adults are widely reported but there are no large published series concerning young children. METHODS: Between December 1996 and February 2002, 48 of 553 patients percutaneously treated at our institution were children age <or=5 years. Indications for closure were: elective closure in 32 patients; frequent respiratory infections in 8; failure to thrive in 2; liver transplantation in 5; and a fenestrated Fontan in 1. The procedure was carried out under general anesthesia with fluoroscopy and transesophageal control. Two different devices were used: 1) the CardioSEAL/StarFLEX (CS/SF) and 2) the Amplatzer septal occluder (ASO). Basal physical examinations and echocardiograms were performed prior to the procedure and at follow-ups (1, 6, and 12 months, and yearly thereafter). RESULTS: The mean age at closure was 3.6 +/- 1.3 years. A CS/SF was used in 10 subjects; an ASO was used in 38 patients. No deaths or immediate major complications occurred. The total occlusion rate was 87% at procedure, rising to 94% at discharge. The mean follow-up was 18 +/- 14 months. No midterm major or minor complications occurred. The occlusion rate rose to 100% at 12 months of follow-up. Symptomatic patients improved significantly. CONCLUSIONS: In the current era and in experienced hands, ASD closure can be performed safely and successfully, even in very young children.
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Authors | Gianfranco Butera, Gabriella De Rosa, Massimo Chessa, Luca Rosti, Diana Gabriella Negura, Piazza Luciane, Alessandro Giamberti, Eduardo Bossone, Mario Carminati |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 42
Issue 2
Pg. 241-5
(Jul 16 2003)
ISSN: 0735-1097 [Print] United States |
PMID | 12875758
(Publication Type: Journal Article)
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Topics |
- Age Factors
- Catheterization
(instrumentation, methods)
- Child, Preschool
- Echocardiography, Transesophageal
(instrumentation, methods)
- Failure to Thrive
(etiology)
- Female
- Fluoroscopy
(instrumentation, methods)
- Follow-Up Studies
- Fontan Procedure
- Heart Septal Defects, Atrial
(complications, diagnostic imaging, physiopathology, therapy)
- Humans
- Infant
- Length of Stay
(statistics & numerical data)
- Liver Transplantation
- Male
- Patient Selection
- Pulmonary Wedge Pressure
- Respiratory Tract Infections
(etiology)
- Safety
- Treatment Outcome
- Ultrasonography, Interventional
(instrumentation, methods)
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