Transcatheter Closure of Atrial Septal Defects: Experience of a Pediatric Heart Center

INTRODUCTION Transcatheter closure of ASDs has become the procedure of choice for treatment of ASDs in many centers (1,2). High success rate, low complication rate, and ease of application are the main advantages of this approach. In this article, we report our experience of transcatheter device closure in children. There have been significant developments over time which resulted in devices with better outcomes. Initial attempts for transcatheter device closures were associated with higher complication rates compared to today (3). This problem was overcome overtime with the better designs of the devices. A retrievable device, Amplatzer septal occluder (AGA Medical Corporation, Golden Valley, Minnesota, USA) became the device of choice for most interventional cardiologists (4,5). In this article, we report our experience in 129 consecutive transcatheter ASD closures between September 1996 and December 2002. We also report our intermediate term followup results. Transcatheter closure of the ASDs has become the procedure of choice for most centers. In this article, we report our experience in 129 children who have undergone transcatheter closure of their ASDs. The balloon stretched diameter of the ASDs ranged between 6 and 28 mm. The immediate success rate for device closure was 92% and closure success rate was 98% at one year follow-up. There was no significant relationship between the ASD size and the initialimplant success rate (p =NS). Multifenestrated ASDs were present in 18% of patients. Significant complications, including device embolization, aortic root erosion, thrombus formation, and 1st degree AV block, occurred in 6% of patients. There were no procedure related deaths, and there were no residual adverse effects in patients who required removal of their devices. Transcatheter device closure of ASDs is an effective and safe procedure with elimination of intraatrial shunts in vast majority of patients, and this should be the procedure of choice for the closure of ASDs which are amenable to device closure.