Transcatheter device closure of secundum atrial septal defect [ASD] in young children

ABSTRACT

To analyze the safety and efficacy of device closure of secundum atrial septal defect in children < 5 years of age. Quasi-experimental study. The study was conducted at Armed Forces Institute of Cardiology / National Institute of Heart Diseases Rawalpindi, Pakistan from Dec 2010 - Dec 2012. Forty eight patients < 5 years of age underwent transcatheter closure of secundum ASD during two years. All patients were evaluated with 2-D echocardiography before the procedure. The sizing balloon was used in 6% and general anaesthesia was given in 83% [n=40] of patients. Ninety seven point nine percent [47/48] had successful closure of ASD. The mean age was 4.1 +/- .68 years [range 2.5-5 years] and 58.4% [28/48] were females. The defect size and occluders used were between 5-20 mm [mean 12 +/- 3.5] and 8-22 mm [mean 15 +/- 3.9] respectively, three patients had simultaneous procedures including pulmonary valvuloplasty in two and percutaneous transmitral commissurotomy [PTMC] in one. The major complications remained 2% [1/48] which included device embolization just after release of device while minor complication rate was 12.5%. The median procedure time was 30 min [15-100 min] and median fluoroscopic time was 6 min [1.50-45 min]. There was no emergency surgical exploration or death during this period. Transcatheter device closure of suitable secundum atrial septal defect is effective and safe in young children in skilled and professional hands