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Efficiency of transcatheter closure of atrial septal defects in small and symptomatic children

Published online by Cambridge University Press:  01 June 2008

Alain Fraisse ,
Jean Losay ,
François Bourlon ,
Gabriella Agnoletti ,
Jean-René Lusson ,
François Godart ,
Bernard De Geeter ,
Jérôme Petit  and
Jean François Piechaud
Alain Fraisse*
Affiliation:
Cardiologie Pédiatrique, Département de Cardiologie, Hôpital La Timone, Marseille, France
Jean Losay
Affiliation:
Centre Chirurgical Marie-Lannelongue, Le Plessis Robinson, France
François Bourlon
Affiliation:
Centre Cardiothoracique de Monaco, Monaco, Paris, France
Gabriella Agnoletti
Affiliation:
Service de Cardiologie Pédiatrique, Hôpital Necker-Enfants-Malades, Paris, France
Jean-René Lusson
Affiliation:
Service de Cardiologie et Maladies Vasculaires, CHU Clermont-Ferrand, Hôpital G Montpied, Clermont-Ferrand, France
François Godart
Affiliation:
Service des Maladies Cardiovasculaires Infantiles et Congénitales, Hôpital Cardiologique, CHRU de Lille, Lille, France
Bernard De Geeter
Affiliation:
Service de Cardiologie, Clinique Sainte Odile, Strasbourg, France
Jérôme Petit
Affiliation:
Centre Chirurgical Marie-Lannelongue, Le Plessis Robinson, France
Jean François Piechaud
Affiliation:
Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Quartier, Massy, France
*
Correspondence to: Alain Fraisse, Cardiologie Pédiatrique, Département de Cardiologie, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France. Tel: (33) 491 38 67 50; Fax: (33) 491 38 56 38; E-mail: alain.fraisse@ap-hm.fr
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Abstract

Objectives

We report the multicentric French experience with transcatheter closure in children weighing 15 kilograms or less, with the aim of assessing the efficacy of the procedure in this age group.

Patients

We included all children weighing 15 kilograms or less, and seen between January, 1997, and June, 2004, who had successful transcatheter closure of an interatrial communication within the oval fossa.

Results

Transcatheter closure was performed in 35 patients weighing 15 kilograms or less, of whom 14 were male and 21 female. The procedures were undertaken in 8 different centres, the patients having a median age of 3 years, with a range from zero to 6.2 years, and a mean weight of 13 kilograms, with a range from 3.6 to 15 kilograms. All the patients were symptomatic, with associated cardiac malformations present in 4 cases, and extracardiac anomalies in 4 patients, including Down’s syndrome in 3, and Adams Oliver syndrome in the other case. In 1 patient, emergency cardiac surgery was needed 24 h after the procedure to correct a previously undiagnosed divided right atrium. No other complication occurred. After a median follow-up of 2 years, with a range from 0.5 to 5.2 years, all the patients are asymptomatic, except for one long-standing patient with bronchodysplasia. In 1 other patient, a small residual bidirectional shunt was detected by echocardiography. No patient presented significant arrhythmia. In the patients followed-up for more than 12 months, we found a significant gain in weight gain.

Conclusion

Transcatheter closure of an interatrial communication within the oval fossa is efficient in children weighing 15 kilograms or less, and can be proposed as a first line of treatment in symptomatic patients. Children with retarded growth tend to have complete recovery within one year of closure.

Keywords

Interatrial communicationsoval fossa defectsinterventional catheterisation
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 3 , June 2008 , pp. 343 - 347
Copyright
Copyright © Cambridge University Press 2008

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