[Mid-term results of percutaneous closure of atrial septal defect in children].
OBJECTIVE
To evaluate the medium-term results of percutaneous closure of atrial septal defect.


METHODS
Twenty-two children (mean weight, 23 11kg; mean age, 5.7 2.4 years) underwent percutaneous atrial septal defect closure under general anesthesia. The procedure was monitored by transesophageal echocardiography. DAS-Angel Wings (n4) and the Amplatzer device (n18) were used.


RESULTS
Mean pulmonary artery pressure was 13 2.8mmHg, mean pulmonary vascular resistance was 1.50.5U/m2 and mean Qp/Qs flow ratio was 2.2 0.6. The mean diameter of the defects was 14.5 6.3mm by transesophageal echocardiography OmniPlane measurement and 15.95.3mm using balloon occlusion reference. A total of 31 devices were used: 4 Angel Wings and 27Amplatzer devices. Twelve Amplatzer devices were withdrawn through the introducer without complications, 5 due to a discrepancy in the size of the left auricle, 4 because they were too small to stabilize in the septum and 3 due to defective opening in the left auricle. In 19 patients implantation was successful. In 17 patients transthoracic color Doppler echocardiography carried out 24 hours after the procedure showed a minimal shunt which was no longer present 1 month later. The mean time of discharge was 38 12 hours after the procedure. After a mean follow up 15 6 months the patients remain asymptomatic with no clinical or technical problems.


CONCLUSIONS
The success rate of percutaneous closure of atrial septal defects in well-selected patients was high and presented no complications.
Sección de Cardiología Pediátrica.Hospital General Universitario Gregorio Marañón, Madrid. zabalan@jet.es
J I
JI
Zabala Argüelles
E
E
García Fernández
E
E
Maroto Alvaro
J L
JL
Zunzunegui Martínez
C
C
Maroto Monedero
F
F
Centeno Malfaz
R
R
Greco Martínez
J L
JL
Delcán Domínguez
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D013997:Time Factors