Background:
This is a retrospective study of patients who underwent ASD device closure using either Amplatzer (ASO) or Lifetech ASD occluder(LSO)from July 2004- October 2008.
Results: 33 patients underwent percutaneous closure who were less than 10 years(range11 months- 10 years,18 <5 years). The procedure was done under conscious sedation in 10 with TTE and the rest under general anesthesia and TEE.The defect size ranged from 10mm -24mm (median:16mm).The device sizes ranged from 10-32mm.The device chosen was the maximum diameter of the defect on echocardiogram (TEE when this was done). Over sizing was done in 4 patients with floppy rims (by 2-4 mm).In 4 patients(age 2-6 years, ASD>15MM),the initial device was replaced by a smaller device due to repeated failure of deployment. Balloon assisted closure was done in 18 patients (Electively in12 with deficient or floppy rims and on failure of initial attempt in the rest).The mean fluoroscopic time was 12 minutes (range 4-40.2 minutes) and the procedural time was 57 minutes (25 to 170 minutes). Follow up echocardiography showed complete closure immediately, at 24 hours, and 1 year in 86%, 92% and 96% for ASO and 92%, 94% and 94% for LSO respectively.
Complications: SVT-2, transient sinus node dysfunction-1, Device embolization-1
Conclusions: The early and intermediate results of transcatheter closure of atrial septal defects shows that it is feasible and safe in children less than 10 years. Balloon sizing was not done in any of the patients. Balloon assisted closure simplifies the procedure especially in patients with floppy rims.