Yves Wyss1, Daniel Quandt1,2, Roland Weber1,2, Brian Stiasny1,2, Benedikt Weber3, Walter Knirsch1,2, Oliver Kretschmar1,2. 1. Paediatric Heart Centre, University Children's Hospital Zurich, Steinwiesstrasse, Zurich, Switzerland. 2. Children's Research Centre, University Children's Hospital Zurich, Switzerland. 3. Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland.
Abstract
AIMS: This study set out to assess indications, feasibility, complications, and clinical outcome of percutaneous transcatheter device closure of atrial septal defects (ASDs) in infants with a bodyweight below 10 kg. METHODS AND RESULTS: Retrospective single center chart and echocardiography review study from 8/2005-12/2013. Twenty-eight children with ASD (13 female) with a median age of 1.15 years (0.2-2.8) and a median weight of 7.2 kg (4.5-9.9) were analyzed. Indications for early ASD closure were failure to thrive (n = 15, 54%), bronchopulmonary dysplasia (BPD) with supplemental oxygen dependency (n = 7, 25%), and genetic syndromes with suspected pulmonary hypertension (n = 12, 43%). Device implantation was successful in all patients without any periprocedural mortality or major complication. Clinical outcome after a median follow-up period of 2.1 years (0.25-7.3) revealed no residual shunt and a significant decrease of right ventricular volume load. Patients with pulmonary hypertension experienced a significant reduction of pulmonary artery/RV pressure. Patients also showed decreased supplemental oxygen dependency and less cardiac medications, but no significant "catch-up growth" in those with failure to thrive. CONCLUSION: Interventional ASD closure in children weighing less than 10 kg can be performed without any additional major risks and shows a favorable outcome, especially in selected patients with significant non cardiac co-morbidities.
AIMS: This study set out to assess indications, feasibility, complications, and clinical outcome of percutaneous transcatheter device closure of atrial septal defects (ASDs) in infants with a bodyweight below 10 kg. METHODS AND RESULTS: Retrospective single center chart and echocardiography review study from 8/2005-12/2013. Twenty-eight children with ASD (13 female) with a median age of 1.15 years (0.2-2.8) and a median weight of 7.2 kg (4.5-9.9) were analyzed. Indications for early ASD closure were failure to thrive (n = 15, 54%), bronchopulmonary dysplasia (BPD) with supplemental oxygen dependency (n = 7, 25%), and genetic syndromes with suspected pulmonary hypertension (n = 12, 43%). Device implantation was successful in all patients without any periprocedural mortality or major complication. Clinical outcome after a median follow-up period of 2.1 years (0.25-7.3) revealed no residual shunt and a significant decrease of right ventricular volume load. Patients with pulmonary hypertension experienced a significant reduction of pulmonary artery/RV pressure. Patients also showed decreased supplemental oxygen dependency and less cardiac medications, but no significant "catch-up growth" in those with failure to thrive. CONCLUSION: Interventional ASD closure in children weighing less than 10 kg can be performed without any additional major risks and shows a favorable outcome, especially in selected patients with significant non cardiac co-morbidities.
Authors: Karan R Kumar; David A Clark; Evan M Kim; Jasmine D Perry; Kaylyn Wright; Sheikisha A Thomas; Elizabeth J Thompson; Rachel G Greenberg; P Brian Smith; Daniel K Benjamin; Matthew M Laughon; Reese H Clark; Christoph P Hornik Journal: J Pediatr Date: 2018-08-29 Impact factor: 6.314
Authors: S Ackermann; D Quandt; N Hagenbuch; O Niesse; M Christmann; W Knirsch; O Kretschmar Journal: J Interv Cardiol Date: 2019-04-07 Impact factor: 2.279