All issues > Volume 52(4); 2009

Original Article

Korean J Pediatr. 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 SH Lee¹, Deok Young DY Choi², Nam Kyun NK Kim¹, Jae Young JY Choi¹, Jun Hee JH 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

Correspondence Jae Young JY 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.

Keywords :Heart septal defects, Atrial, Heart catheterization, Device, Child