Korean Circ J.  2016 Nov;46(6):851-861. 10.4070/kcj.2016.46.6.851.

Comparison of Transcatheter Atrial Septal Defect Closure in Children, Adolescents and adults: Differences, Challenges and Short-, Mid- and Long-Term Results

• Saritas T
• Yucel IK
• Demir IH
• Demir F
• Erdem A
• Celebi A

• KMID: 2355463
• DOI: http://doi.org/10.4070/kcj.2016.46.6.851

Abstract

BACKGROUND AND OBJECTIVES
This study aims to compare the characteristics, effectiveness and results of transcatheter closure of atrial septal defect between children, adolescents, and adults.
SUBJECTS AND METHODS
In this study, 683 patients who underwent atrial septal defect closure in the last 10 years were divided into three groups: children (age <12), adolescents (age 12 to 16), and adults (age >16) as group 1, group 2 and group 3, respectively.
RESULTS
The average defect size and incidence of complex atrial septal defect were higher in group 3 (p=0.0001 and 0.03 respectively). While the average size of the devic was higher in adults (22.6±6.4 mm vs. 18.5±4.9 mm; p=0.0001), the ratio of the device size/total septum was higher in both children and adolescents (Group 1 and 2). In the child and adolescent groups and patients with only complex atrial septal defect, the use of techniques, other than standard deployment, was similar in all three groups (p=0.86 and 0.41, respectively). The ratio of the residual shunt was similar in all three groups. Major complications were seen in 5 cases (4 cases with migration, and 1 case with dislocation) in group 3 and 1 case (migration) in group 1.
CONCLUSION
Depending on the complexity of the defect and age of the patient, transcatheter closure of atrial septal defect might have certain difficulties and complications. Patients must be evaluated in detail to avoid major complications and possible problems during the procedure.

Keyword

Atrial septal defect; Septal occluder; Children; Adult

MeSH Terms

Adolescent*
Adult*
Child*
Heart Septal Defects, Atrial*
Humans
Incidence
Septal Occluder Device

Figure

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  Fig. 1 Three atrial septal occluders in the same patient. Thin and thick long arrows show the first 2 devices previously implanted by sandwich method, the short arrow indicates proximal end of the third device implanted in a different session.

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  Fig. 2 Aneurysmatic septum and three defects at bicaval position on transesophageal echocardiography in a 10-year-old female patient performed balloon septoplasty.

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