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Background: Transcatheter device closure of ostium secundum atrial septal defect is a safe & effective intervention in older children, & is usually done under transesophageal echocardiography guidance. However, the procedure under transthoracic echocardiography guidance, especially in smaller children, is done only at few centers, the data of which is scarce. Methods: A prospective study was undertaken to assess the mid-term efficacy and outcome of transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiographic guidance, in children <15 Kg. Results: Eighty three children with ostium secundum atrial septal defect were included in the study. Median age of the study population was 3.5 years (1.9-5.6 years), and median weight of 11.6 Kg (7.6 - 14.9 Kg). The primary and secondary procedural success rates were 94% and 96.4% respectively. Post procedure patients were followed up for 12-30 months. Device related major complications were encountered in 4 (4.8%) cases. The total occlusion rates of the defect at 24 hours, 1 month and 3 months post procedure were 94%, 98.8% and 100% respectively. Conclusion: The transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiography guidance, in children <15 Kg, has a high short and mid-term safety and efficacy.
ABSTRACT
Objective To investigate clinical effect and safety of ostium secundum atrial septal defect(ASD) treatment via one -stop hybrid and classical surgical procedures.Methods 45 patients were diagnosed ostium secun-dum simple ASD by ultrasound cardiogram and clinical manifestation,they were divided into one -stop hybrid proce-dure group (n =20)and classical surgical procedure (n =25).Age,gender,weight,post operation hospital day,on -pump time,blood transfusion amount,drainage flow,incision length and incidence of complication between the two groups were compared.Results Age and weight had no difference between the two groups(t =0.40 and 1.64,P >0.05),but the proportion of female cases in one -stop hybrid procedure group was higher than post operation(χ2 =9.45,P 0.05).And one -stop hybrid procedure group was off -pump without blood transfusion.Conclusion One -stop hybrid procedure was simple,could make a quick recovery post operation and was an ideal method for ostium secundum ASD treatment.
ABSTRACT
PURPOSE: To know the natural course of the ostium secundum ASD including its rate of spontaneous closure. METHODS: We studied 259 cases who were diagnosed as ostium secundum ASD by 2D-echocardiography at Department of Pediatrics, Kyungpook National University Hospital between Jan. 1985 and Dec. 1994. According to the age at diagnosis, we divided them into two groups, group I (those diagnosed before 1 month of age: 59 cases) and group II (those diagnosed after 1 month of age: 200 cases) RESULTS: Mean age at first diagnosis was 2.6+/-4.6 years and mean defect size(diameter by 2D-echocardiography) was 9.9+/-8.0 mm. Cardiac murmur was the main reason to refer the patients to hospital, being in 50 cases(87%) in group I, 179 cases(90%) in group II. Defect sizes were significantly small in group I compared with group II (5.3+/-3.4 mm vs 11.1+/-6.9 mm, p<0.05). Symptoms corresponding to congestive heart failure were present in 16 cases of group I (27%)( isolated ASD: 8 cases, ASD accompanying with PDA: 5 cases, ASD accompanying with VSD: 2 cases, ASD accompanying both PDA and VSD : 1 case) and in 27 cases of group II(13.5%) (isolated ASD: 17 cases, ASD accompanying with VSD: 4 cases, ASD accompanying with PDA: 4 cases, ASD accompanying both PDA and VSD: 2 cases). Of total 139 cases, spontaneous closure of ostium secundum ASD was documented in 14 cases(10.1%) by follow up 2D-echocardiography. The rate of spontaneous closure was significantly high in group I compared with group II (6 cases: 37.5% vs 8 cases: 6.5%, p<0.05) Comparing with those cases without closure, there were no significant differences in defect size in group I but significant differences in group II(p<0.05), being 5.63 2.62 mm in cases with spontaneous closure and 12.82 7.09 mm in those cases without closure. Of the 9 cases with atrial septal septal aneurysm, 2D- echocardiographic follow ups were possible in 5 cases with spontaneous closure in 2 (40%). CONCLUSIONS: Spontaneous closure was documented in 10.1% of all the patients with ostium secundum ASD. Especially the closure rate was significantly high in those cases their diagnosis was made before 1 month of age and with atrial septal aneurysm.