Zakaria Jalal1, Sébastien Hascoët2, Céline Gronier3, François Godart4, Lucia Mauri5, Claire Dauphin6, Bruno Lefort7, Matthias Lachaud8, Dominique Piot5, Marie-Lou Dinet9, Yael Levy9, Alain Fraisse10, Caroline Ovaert10, Xavier Pillois11, Jean-René Lusson6, Jérôme Petit5, Alban-Elouen Baruteau12, Jean-Benoit Thambo13. 1. Bordeaux University Hospital (CHU), Department of Paediatric and Adult Congenital Cardiology, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France. Electronic address: jalalzakaria1@gmail.com. 2. M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery Department, Paris Sud University, Plessis-Robinson, France; Department of Paediatric Cardiology, Hopital des Enfants, Paul-Sabatier University, CHU de Toulouse, Toulouse, France. 3. Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte, Strasbourg, France. 4. CHRU de Lille, University Lille Nord-de-France, Faculté de Médecine, Hôpital Cardiologique, Service des Maladies Cardiovasculaires Infantiles et Congénitales, Lille, France. 5. M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery Department, Paris Sud University, Plessis-Robinson, France. 6. Service de Cardiologie et Maladies Cardiovasculaires, Hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France. 7. Unité de Cardiologie Pédiatrique, Hôpital des Enfants Gatien de Clocheville, INSERM UMR 1069 et Université François Rabelais, Tours, France. 8. Inserm UMR 1087-CNRS UMR6291, Institut du Thorax, Nantes University, Nantes, France. 9. Bordeaux University Hospital (CHU), Department of Paediatric and Adult Congenital Cardiology, Pessac, France. 10. Paediatric and Congenital Cardiology, La Timone Hospital, M3C CHU de Marseille, Marseille, France. 11. IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France. 12. Department of Congenital Cardiology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. 13. Bordeaux University Hospital (CHU), Department of Paediatric and Adult Congenital Cardiology, Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France.
Abstract
OBJECTIVES: This study sought to assess procedural characteristics, early clinical outcome, and long-term complications after transcatheter closure of atrial septal defect (ASD) in children. BACKGROUND: Transcatheter closure has become the preferred strategy in most cases of isolated secundum ASD. However, reported experience in the pediatric population is limited. METHODS: A 1998 to 2016 retrospective multicenter study was performed in 9 French tertiary institutions. All children who had an attempt of percutaneous ASD closure with an Amplatzer Septal Occluder were included. RESULTS: In 1,326 children (39% males; median age, 9 years [0.7 to 18]; weight, 29 kg [3.6 to 92]), transcatheter ASD closure was performed. Median ASD size was 15 mm (3 to 41); 254 (19.1%) patients had a large ASD (≥20 mm/m2). Procedural success rate was 95.3% (95% confidence interval: 93.9% to 96.3%). No death was observed but periprocedural complications occurred in 24 patients (1.8%). After a median follow-up of 3.5 years (range 6 months to 18 years; 173 patients [13%] followed >10 years), delayed major complications were minimal (n = 12; 1.04%) including no death and/or cardiac erosion. Periprocedural and delayed complications rates were significantly higher in children ≤15 kg (5.2% vs. 1.5%; p = 0.007 and 3.1% vs. 0.7%; p < 0.007, respectively) and those with large ASD (3.5% vs. 1.4%; p = 0.008 and 1.7% vs. 0.7%; p = 0.052, respectively). CONCLUSIONS: Transcatheter ASD closure using Amplatzer Septal Occluder is safe in children with a minimal rate of periprocedural complications and a favorable long-term outcome, especially with no death or cardiac erosion despite a substantial proportion of large defects. Children ≤15 kg and those with large ASDs had a greater risk of complications.
OBJECTIVES: This study sought to assess procedural characteristics, early clinical outcome, and long-term complications after transcatheter closure of atrial septal defect (ASD) in children. BACKGROUND: Transcatheter closure has become the preferred strategy in most cases of isolated secundum ASD. However, reported experience in the pediatric population is limited. METHODS: A 1998 to 2016 retrospective multicenter study was performed in 9 French tertiary institutions. All children who had an attempt of percutaneous ASD closure with an Amplatzer Septal Occluder were included. RESULTS: In 1,326 children (39% males; median age, 9 years [0.7 to 18]; weight, 29 kg [3.6 to 92]), transcatheter ASD closure was performed. Median ASD size was 15 mm (3 to 41); 254 (19.1%) patients had a large ASD (≥20 mm/m2). Procedural success rate was 95.3% (95% confidence interval: 93.9% to 96.3%). No death was observed but periprocedural complications occurred in 24 patients (1.8%). After a median follow-up of 3.5 years (range 6 months to 18 years; 173 patients [13%] followed >10 years), delayed major complications were minimal (n = 12; 1.04%) including no death and/or cardiac erosion. Periprocedural and delayed complications rates were significantly higher in children ≤15 kg (5.2% vs. 1.5%; p = 0.007 and 3.1% vs. 0.7%; p < 0.007, respectively) and those with large ASD (3.5% vs. 1.4%; p = 0.008 and 1.7% vs. 0.7%; p = 0.052, respectively). CONCLUSIONS: Transcatheter ASD closure using Amplatzer Septal Occluder is safe in children with a minimal rate of periprocedural complications and a favorable long-term outcome, especially with no death or cardiac erosion despite a substantial proportion of large defects. Children ≤15 kg and those with large ASDs had a greater risk of complications.
Authors: Tejasvi Kashyap; Muhammad Sanusi; Elina S Momin; Asma A Khan; Vijayalakshmi Mannan; Muhammad Ahad Pervaiz; Aqsa Akram; Abeer O Elshaikh Journal: Cureus Date: 2022-05-27
Authors: Ah Young Kim; Wongi Woo; Beom Jin Lim; Jo Won Jung; Jae Young Choi; Young Jin Kim Journal: Circ Cardiovasc Imaging Date: 2022-07-19 Impact factor: 8.589