Transcatheter closure of atrial septal defect with Amplatzer device in children aged less than 10 years old: immediate and late follow-up.
OBJECTIVE
To analyze the efficacy and follow-up results of percutaneous closure of Atrial septal defect (ASD) with the Amplatzer septal occluder in children aged <10 years old.


METHODS
Between November 1998 and September 2005, 27 patients diagnosed with ASD were treated percutaneously with an Amplatzer septal occluder. The procedure was carried out in the cathlab, under general anesthesia and with both fluoroscopy and transesophageal echocardiography guidance. Basal physical examinations and echocardiograms were performed prior to the procedure and at 30 days, 6, and 12 months of follow-up. Survival free of symptom was estimated by Kaplan-Meier.


RESULTS
The mean age, weight, height, body mass index, and corporal surface was: 5.35 +/- 2.11 years, 23.07 +/- 9.43 kg, 110.55 +/- 17.6 cm, 16.77 +/- 2.42 kg/m(2), and 1.24 +/- 2.44 m(2). The prevalence of septal aneurysm was 3.7% and all patients presented single secundum ASD. The mean stretched diameter by fluoroscopy and transesophageal echocardiography were 17.18 +/- 6.75 mm and 16.77 +/- 5.99 mm, and the prostheses sizes were 18.83 +/- 6.98 mm, ranging from 10 to 30 mm. The systolic and diastolic pulmonary pressures were 25.26 +/- 5.97 mm Hg and 13.38 +/- 3.40 mm Hg, respectively. The procedure time was 82.92 +/- 29.14 min and the hospital stay was 2.20 +/- 0.26 days. Clinical and echocardiography follow-ups were performed within 11.59 +/- 4.42 months and all devices were in the correct position with no residual shunt. Right ventricular diameter decreased from 19.38 +/- 5.23mm to 11.38 +/- 11.92 (P 0.001). No major complications or deaths occurred; two patients had a hematoma at the vascular access.


CONCLUSIONS
Secundum atrial septal defect closure can be safely and successfully performed with the Amplatzer septal occluder in children younger than 10 years old.
Rossi
Raul I
RI
Department of Interventional Cardiology, Institute of Cardiology of Rio Grande Do Sul, Porto Alegre-RS, Brazil. editoracao-pc@cardiologia.org.br
Cardoso
Cristiano de Oliveira
Cde O
Machado
Paulo Renato
PR
Francois
Lisia Galant
LG
Horowitz
Estela Suzana K
ES
Sarmento-Leite
Rogerio
R
D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D019736:Prostheses and Implants; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D019919:Prosthesis Implantation / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome