title: Percutaneous versus surgical closure of atrial septal defects in children and adolescents.
abstract: BACKGROUND
  There is a scarcity of data comparing percutaneous and surgical closure of the secundum atrial septal defect (ASD).
  
  
  OBJECTIVE
  Assessment of safety and efficacy of both methods of treatment in a referral center affiliated with the Ministry of Health.
  
  
  METHODS
  Observational, prospective, non-randomized study of two cohorts of children and adolescents younger than 14 years, treated by catheterization or surgery. Data was collected prospectively in the percutaneous group (A) and retrospectively in the surgical group (B).
  
  
  RESULTS
  A total of 75 patients (pts) were enrolled in group A from April 2009 to October 2011 and 105 pts were treated in group B from January 2006 to January 2011. Age was older and weight was higher in group B and the ASD diameter was similar in both groups. Technical success was achieved in all procedures and there were no deaths. Complications (most minor) occurred in 68% of group B and 4% of A (p < 0.001). Rates of total occlusion or non-significant residual shunts were similar in both groups. Median hospitalization time was 1.2 days in group A and 8.4 days in group B (p < 0.001).
  
  
  CONCLUSIONS
  Both treatment modalities are safe and effective, showing excellent outcomes. However, the percutaneous treatment has lower morbidity and shorter in-hospital stay length. These observations support the concept that percutaneous treatment of atrial septal defects should be regarded as the method of choice to manage selected patients with this condition.
authors.affiliation: Hospital do Coração da Associação Sanatório Sírio, São Paulo, SP, Brazil. rncosta@gmail.com
authors.forename: Rodrigo Nieckel da
authors.initials: RN
authors.lastname: Costa
authors.forename: Marcelo Silva
authors.initials: MS
authors.lastname: Ribeiro
authors.forename: Fabricio Leite
authors.initials: FL
authors.lastname: Pereira
authors.forename: Simone Rolim Fontes
authors.initials: SR
authors.lastname: Pedra
authors.forename: Marcelo Biscegli
authors.initials: MB
authors.lastname: Jatene
authors.forename: Ieda Biscegli
authors.initials: IB
authors.lastname: Jatene
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Ferreiro
authors.forename: Maria Virginia Tavares
authors.initials: MV
authors.lastname: Santana
authors.forename: Valmir Fernandes
authors.initials: VF
authors.lastname: Fontes
authors.forename: Carlos Augusto Cardoso
authors.initials: CA
authors.lastname: Pedra
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome