Efficacy and safety of using amplatzer for transcatheter closure of atrial septal defect in small children with less than ۱۰ kg

BACKGROUND: Atrial septal defect (ASD) accounts for about ۱۰% of congenital heart diseases (CHDs). Self-closure of these defects in patients with defects less than ۸ mm has been reported in several studies. In children, transcatheter closure of the ASD is suggested for asymptomatic patients older than two years and with weight > ۱۵ kg. The purpose of this study was to show that transcatheter closure of ASD in small children with body weight less than ۱۰ kg is an effective and safe method.METHODS: Between July ۲۰۱۶ and September ۲۰۱۸, ۳۵ children with body weight less than ۱۰ kg underwent percutaneous closure of ASD using amplatzer. All patients had minimum defect size of ۶ mm, pulmonary blood flow (Qp) to systemic blood flow (Qs) ratio above ۱.۵, right atrial and ventricular dilation, symptoms of delayed growth, and recurrent respiratory infections in their evaluation and had acceptable rims for intervention. Follow-up evaluations were done ۱ day, ۱ week, ۱ month, ۶ months, and yearly after discharge with transthoracic echocardiography (TTE) and electrocardiography (ECG).RESULTS: The mean age of patients at procedure was ۱۲.۰۶ ± ۴.۴۷ months (range: ۶ to ۱۴ months), mean weight was ۸.۳۲ ± ۰.۷۲ kg (range: ۷.۵ to ۹.۸ kg). The mean defect size was ۱۰.۰۰ ± ۲.۳۲ mm (range: ۶-۱۳ mm). The mean device size used was ۱۰.۵۷ ± ۲.۵۷ mm (range: ۷.۵ to ۱۵ mm). Mean duration of follow-up was ۱۶.۶۶ ± ۶.۹۳ months (range: ۱-۲۹ months). Respiratory rate, heart rate, pulmonary stenosis (PS), and Qp to Qs ratio had significant difference before and after procedure during the follow up (P < ۰.۰۰۱).CONCLUSION: Transcatheter closure of ASD with amplatzer in symptomatic small children and infants is a safe and effective treatment associated with excellent success, but long-term follow-up in a large number of patients would be warranted.

Keywords:

Atrial Septal Defect , Devices , Septal Occluder