Interventional Closure of Secundum Type Atrial Septal Defects in Infants Less Than 10 Kilograms: Indications and Procedural Outcome.

Journal of interventional cardiology

PubMedID: 27625018

Wyss Y, Quandt D, Weber R, Stiasny B, Weber B, Knirsch W, Kretschmar O. Interventional Closure of Secundum Type Atrial Septal Defects in Infants Less Than 10 Kilograms: Indications and Procedural Outcome. J Interv Cardiol. 2016;.
AIMS
This study set out to assess indications, feasibility, complications, and clinical outcome of percutaneous transcatheter device closure of atrial septal defects (ASDs) in infants with a bodyweight below 10?kg.

METHODS AND RESULTS
Retrospective single center chart and echocardiography review study from 8/2005-12/2013. Twenty-eight children with ASD (13 female) with a median age of 1.15 years (0.2-2.8) and a median weight of 7.2?kg (4.5-9.9) were analyzed. Indications for early ASD closure were failure to thrive (n?=?15, 54%), bronchopulmonary dysplasia (BPD) with supplemental oxygen dependency (n?=?7, 25%), and genetic syndromes with suspected pulmonary hypertension (n?=?12, 43%). Device implantation was successful in all patients without any periprocedural mortality or major complication. Clinical outcome after a median follow-up period of 2.1?years (0.25-7.3) revealed no residual shunt and a significant decrease of right ventricular volume load. Patients with pulmonary hypertension experienced a significant reduction of pulmonary artery/RV pressure. Patients also showed decreased supplemental oxygen dependency and less cardiac medications, but no significant "catch-up growth" in those with failure to thrive.

CONCLUSION
Interventional ASD closure in children weighing less than 10?kg can be performed without any additional major risks and shows a favorable outcome, especially in selected patients with significant non cardiac co-morbidities.