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Transcatheter Closure for Small, Asymptomatic Children Can Still be Deferred
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Researchers of a recent study have found that elective transcatheter closure of secundum atrial septal defects in asymptomatic children who weigh less than 15 kg should be deferred until the traditional age of 4 to 5 years.
“Delaying closure in otherwise symptomatic children has no deleterious effect and only potentially places the child at increased risk of a complication if done sooner. This includes atrial septal defects that are large and will not spontaneously close,” study investigator Sergio Bartakian, MD, told Cardiology Today’s Intervention.
The retrospective review included all children (n=128) who underwent elective closures from March 2000 to April 2010. Children had a median procedural age of 1.92 years (range, 3 months to 4.92 years) and median weight of 10.8 kg (range, 4.3 kg to 14.9 kg).
The success rate was 98% (125 of 128) with one device removal and two procedures halted before a device was placed. There were seven major (5.5%) complications among five children, none of which were medium- or long-term, and 12 minor (9.4%) complications, none of which were reported beyond 7 days after the procedure.
In addition, nearly two-thirds of referrals were for right heart enlargement or poor growth, and rate of resolution of residual shunt was 99%. When compared with age, Bartakian and colleagues observed no difference in the rate of resolution of right heart enlargement. There was also no clinically significant improvement in growth.
Disclosure: Bartakian report no relevant financial disclosures.