Transcatheter Closure of Atrial Septal Defect in Children: Short and Long Term Follow-up Results

Abstract

Background: Atrial septal defect (ASD) is a congenital heart disease which is usually diagnosed in childhood. However the large part of studies in literature include adults. In this study, we aimed to evaluate the follow-up results of patients who had transcatheter closure of ASD to understand the factors effected success and complications of this procedure in children. Methods: 232 patient files were evaluated retrospectively. 24 of the patients excluded from the study as the files of these patients could not be found in archive or the data needed to be evaluated was missing. Demographical data, family history, accompanying syndromes, complaints of patients, symptoms, echocardiographical (ECO) findings, transesophageal echocardiogram (TEE) findings if performed, the size of defect in balloon-sizing, the size of device used in procedure, major and minor complications evaluated. Results: In our study, 208 children [39.9% (n = 83) male, 60.1% (n = 125) female] included who were diagnosed with ASD. The mean age of the patients are 88,06 ± 56,52 months (3 days to 220 months). When the family history is examined; heart disease was not found in 87.0% (n = 181) of the patients whereas 13.0% (n = 27) of the patients had family history of heart disease. 81.7% of the patients (n = 170) had no complaint and 18.3% (n = 38) had complaints. There was a statistically significant correlation between diameter and length of defect measured with ECO, TEE and by balloon-sizing. Success rates of procedure found to be 95.7%. While the major complication of the procedure was device embolization; arrythmia was the most common minor complication. None of our patients died due to device embolization. The procedure complication rate is not statistically different according to the device type. (p = 0.075; p> 0.05) Conclusion: In our study, we found that device diameters measured by different methods correlated with each other. The procedure complication rates do not differ according to the device type. When the transcatheter ASD closure process is performed with an experienced and qualified team; mortality and morbidity rates compatible with developed countries can be achieved.