Transcatheter Occluder Devices for the Closure of Atrial Septal Defect in Children: How Safe and Effective Are They? A Systematic Review

Abstract

Atrial septal defect (ASD) is a hole in the interatrial septum (IAS) of the heart that is one of the most common congenital heart diseases (CHD). Percutaneous transcatheter device occlusion is one of the techniques that have been developed for the closure of atrial septal defects. The primary objective of this study is to assess the safety and efficacy of septal occluder devices in the management of atrial septal defect in children. We searched PubMed, Science Direct, and Google Scholar databases to collect relevant articles according to a predetermined eligibility criteria and included 21 papers of different study designs in this systematic review. We found that transcatheter closure is safe and effective in most children with ASD. The major complications reported could be avoided by comprehensive clinical assessment and echocardiographic evaluation to determine appropriate device size and implantation strategy per individual child. Further research involving more clinical trials with larger sample size and longer duration of followup is required to improve the safety of existing devices for their use in all children with ASD despite their weight and defect size, and also the efficacy of newer devices such as biodegradable septal occluders.

Percutaneous Secundum Atrial Septal Defect Closure: Failure Rate and Procedural Predictors

“…ASD accounts for 35% of all congenital heart defects in children. 1,2 The most common defect in ASD is ostium secundum defect, which is one of the defects that can be closed percutaneously. Percutaneous/transcatheter ASD closure has been performed with a total of 112 patients (children and adults) and 14 patients (12.5%) who did not succeed in percutaneous defect closure, 4 adult patients (8%) and 10 pediatric patients (16.13%).…”

“…Ostium secundum defects are the most prevalent defects in ASD with an incidence of 144/100,000 live births. 1,2 Spontaneous closure of ASD can occur in the first year of life, especially if a defect measuring <5 mm is found, while defects >1 cm generally require defect closure. [3][4][5] Defect closure with a surgical procedure is one of therapeutic options, Nonetheless, over the last 40 years, percutaneous defect closure has become an alternative.…”

Surgical Atrial Septal Patch Endocarditis in a Patient with a Complete Corrected Atrioventricular Canal Defect: A Case Report and Review of the Literature

“…Atrial septal defects larger than 1 cm require percutaneous or surgical closure. Previously, surgical closure was the standard of care for ASD, but over the last 30 years, transcatheter devices have rapidly emerged as the gold standard for ostium secundum ASD [6]. Infectious complications of atrial septal occluder devices represents about 0.1% of cases [7].…”