title: Transcatheter closure of atrial septal defects without fluoroscopy: a well-established procedure for alternative use in children.
abstract: OBJECTIVE
  The feasibility of transcatheter closure of atrial septal defects (ASD) without fluoroscopy has been proven. However, the technique has not been accepted for routine use. We report our experience with trans-catheter closure of ASD without fluoroscopy and introduce a well-established technique for alternative use in children.
  
  
  RESULTS
  From November 2013 to May 2015, a total of 114 children with isolated secundum ASD (diameter 6 mm to 24 mm, median 13.8 mm) underwent attempted transcatheter device closure under the guidance of transoesophageal echocardiography without fluoroscopy. Using a modified delivery system and procedure technique, ASD were successfully closed in 110 patients (96.5%, 52 males, 58 females, aged from three to 14 years, median 5.4 years, weight 12 to 46 kg, median 23.5 kg). Procedure time ranged from eight to 42 minutes (median 18 min). Three patients underwent percardiac device closure after failed procedures. In the early stage of our study, before delivery system and technique modification, one patient was converted to open heart surgery due to rupture of the left appendage. No intervention-related complications were detected during a median follow-up of nine months.
  
  
  CONCLUSIONS
  Using a modified delivery system and a re-established procedure, we showed that transcatheter closure of ASD without fluoroscopy is a safe technique for alternative use in children.
authors: Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors: Yifeng
authors: Y
authors: Yang
authors: Weizhi
authors: W
authors: Zhang
authors: Qin
authors: Q
authors: Wu
authors: Lei
authors: L
authors: Gao
authors: Wancun
authors: W
authors: Jin
authors: Tianli
authors: T
authors: Zhao
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome