Mid-term Safety and Efficacy of Transcatheter Closure of Ostium Secundum Atrial Septal Defect under Transthoracic Echocardiographic Guidance in Children Weighing Less than 15 Kg
Harmeet Singh Arora
Department of Cardiology, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
Prashant Bharadwaj
Department of Cardiology, Army Hospital (Research and Referral), Delhi University, Delhi Cantt, New Delhi -110010, India.
Davinder Singh Chadha *
Department of Cardiology, Command Hospital (Air Force), RGUHS, Bengaluru – 560007, Karnataka, India.
Susheel Malani
Department of Cardiology, Army Hospital (Research and Referral), Delhi University, Delhi Cantt, New Delhi -110010, India.
Arijit Kumar Ghosh
Department of Cardiology, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
Kamal Pathak
Department of Radiology, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
Deepak Shukla
Department of Anaesthesia, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
Sachin Shouche
Department of Anaesthesia, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
Satish Kumar Mishra
Department of Anaesthesia, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
Jaswinder Singh
Department of CTVS, Command Hospital (Air Force), RGUHS, Bengaluru – 560007, Karnataka, India.
Brijindera S. Sethi
Department of Anaesthesia, Military Hospital (Cardiothoracic Centre), C/o Armed Forces Medical College, MUHS, Pune – 411040, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Transcatheter device closure of ostium secundum atrial septal defect is a safe & effective intervention in older children, & is usually done under transesophageal echocardiography guidance. However, the procedure under transthoracic echocardiography guidance, especially in smaller children, is done only at few centers, the data of which is scarce.
Methods: A prospective study was undertaken to assess the mid-term efficacy and outcome of transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiographic guidance, in children <15 Kg.
Results: Eighty three children with ostium secundum atrial septal defect were included in the study. Median age of the study population was 3.5 years (1.9-5.6 years), and median weight of 11.6 Kg (7.6 - 14.9 Kg). The primary and secondary procedural success rates were 94% and 96.4% respectively. Post procedure patients were followed up for 12-30 months. Device related major complications were encountered in 4 (4.8%) cases. The total occlusion rates of the defect at 24 hours, 1 month and 3 months post procedure were 94%, 98.8% and 100% respectively.
Conclusion: The transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiography guidance, in children <15 Kg, has a high short and mid-term safety and efficacy.
Keywords: Ostium secundum atrial septal defect, transthoracic echocardiography, transesophageal echocardiography, right heart enlargement