title: Transcatheter closure of atrial septal defect in children up to 10 kg of body weight with Amplatzer device.
abstract: BACKGROUND
  Transcatheter closure of atrial septal defect (ASD) in older children and adults is currently considered the first-choice therapeutic option. This approach remains challenging in younger children. The aim of the study was to evaluate feasibility, safety and midterm efficacy of percutaneous ASD closure in symptomatic infants ≤10 kg body weight in our institution.
  
  
  METHODS
  There were 28 children up to 10 kg of body weight, who were qualified for transcatheter closure of ASD. All patients but one showed overload of right atrium and right ventricle. Mean weight of patients who underwent transcatheter closure was 9.2 ± 0.88 kg and age 1.59 ± 0.58 years, respectively. Transcatheter closure of ASD was conducted using Amplatzer occluders (ASO).
  
  
  RESULTS
  The devices were implanted successfully in 26/28 patients (93%). In 2 (7%) children the device repeatedly straddled the septum in relatively big ASD and the procedure was abandoned. Mean ASD diameter in patients, who underwent transcatheter closure, was 9.08 ± 2.9 mm (transthoracic echocardiography) and mean implant size/weight ratio was 1.07 ± 0.31. In the child with right-left shunt through ASD normalization of saturation occurred. Mean fluoroscopy time was 4.16 min. In 3 children minor complications occurred: transient arrhythmias (n = 1), fever after procedure (n = 2). The follow-up time was 6.1 (range 1.2-11) years. At follow-up, clinical condition and/or growth improved in all patients except 4 children with coexisting comorbidity. No arrhythmia nor conduction disturbances were observed during follow-up.
  
  
  CONCLUSIONS
  In selected patients weighing less or equal to 10 kg, percutaneous closure of ASD is a safe and effective procedure.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Knop
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szkutnik
authors.forename: Roland
authors.initials: R
authors.lastname: Fiszer
authors.forename: Beata
authors.initials: B
authors.lastname: Białkowska
authors.forename: Jan
authors.initials: J
authors.lastname: Głowacki
authors.affiliation: Śląski Uniwersytet Medyczny. jabi_med@poczta.onet.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Białkowski
mesh_terms: D001835:Body Weight; D006328:Cardiac Catheterization / Q000379:methods*; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D055989:Septal Occluder Device; D016896:Treatment Outcome