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The efficacy and safety of transcatheter closure of atrial septal defect with Amplatzer septal occluder in young children less than 3 years of age

Korean Journal of Pediatrics 2009;52(4):494-498.
Published online April 15, 2009.
The efficacy and safety of transcatheter closure of atrial septal defect with Amplatzer septal occluder in young children less than 3 years of age
Soo Hyun Lee1, Deok Young Choi2, Nam Kyun Kim1, Jae Young Choi1, Jun Hee Sul1
1Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
2Division of Pediatric Cardiology, Gil Heart Center, Gachon University of Medicine, Incheon, Korea
3세 미만 심방중격결손 소아에서 Amplatzer 기구 폐쇄술의 안전성 및 효용성
이수현1, 최덕영2, 김남균1, 최재영1, 설준희1
1연세대학교 의과대학 심장혈관병원, 소아심장과
2가천의과대학교병원 의과대학 소아과학교실
Correspondence: 
Jae Young Choi, Email: cjy0122@yuhs.ac
Abstract
Purpose
: Applicability of transcatheter closure of atrial septal defect (ASD) has been expanded by accumulation of clinical experiences and evolutions of the device. This study was performed to evaluate the safety and efficacy of transcatheter closure of ASD with Amplatzer septal occluder (ASO) in young children less than 3 years of age.
Methods
: From May 2003 to December 2005, 295 patients underwent transcatheter closure of ASD with ASO in the Severance Cardiovascular Hospital, Yonsei University Health System. Among them, 51 patients less than 3 years of age were enrolled in this study. We investigated procedural success rate, rate of residual shunt, frequency of complications, procedure/fluoroscopy time, and need of modified techniques for device implantation.
Results
: The median age was 2.1 years and median body weight was 12 kg. Implantation of device was successful in 50 patients (98%). Seven patients (15%) showed a small residual shunt 1 day after the procedure, but complete occlusion had been documented at 6 month follow-up in all patients (100%). The pulmonary to systemic flow ratio (Qp/Qs), peak systolic pulmonary artery pressure, and peak systolic right ventricular pressure had decreased significantly after closure of ASD. There were 2 complications including device embolization (1, 2%) and temporary groin hematoma (1, 2%).
Conclusion
: Transcatheter closure of ASD with ASO can be performed with satisfactory results and acceptable risk even in young children less than 3 years of age. We could suggest that even in very young children with ASD, there is no need to wait until they grow to a sufficient size for the transcatheter closure.
Key Words: Heart septal defects, Atrial, Heart catheterization, Device, Child


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