Bishnoi Ram N, Everett Allen D, Ringel Richard E, Owada Carl Y, Holzer Ralf J, Chisolm Joanne L, Radtke Wolfgang A, Scott Lim D, Rhodes John F, Coulson John D
Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans street M2328, Baltimore, MD, 21287, USA,
Pediatr Cardiol. 2014 Oct;35(7):1124-31. doi: 10.1007/s00246-014-0905-7. Epub 2014 Apr 11.
This study aimed to assess the technical aspects of atrial septal defect (ASD) closure using the Amplatzer septal occluder (ASO) and the Gore Helex septal occluder (GHSO) for infants weighing less than 8 kg and to determine the safety, effectiveness, and near-to-intermediate-term outcome of the closure. The Mid-Atlantic Group of Interventional Cardiology Registry of percutaneous, transcatheter ASD closure procedures was reviewed for this analysis. Patients from 10 hospitals in the United States were included. The cohort for this report consisted of 68 patients weighing less than 8 kg (range, 2.3-7.8 kg; mean, 5.5 ± 1.6 kg) and ranging in age from 1 to 24 months (mean, 8.6 ± 4.7 months). The indications for ASD closure were failure to thrive, significant right heart enlargement, shunts otherwise thought to be hemodynamically significant, and poor overall clinical status. Devices were successfully implanted in 66 of the 68 infants (97.1 % procedural success rate). Five minor procedure-related complications occurred. At follow-up assessment, clinical status had improved significantly as measured by improved weight gain and decreased ventilator or oxygen dependence. All residual shunts spontaneously closed during the follow-up period. Six late deaths occurred, none of which were clearly device related. The ASO and GHSO can be safely and effectively implanted for ASD closure in infants weighing less than 8 kg. These procedures usually are successful and seldom complicated, resulting in significant clinical improvement.
本研究旨在评估使用Amplatzer房间隔封堵器（ASO）和Gore Helex房间隔封堵器（GHSO）对体重小于8 kg的婴儿进行房间隔缺损（ASD）封堵的技术方面，并确定封堵的安全性、有效性以及近中期结果。为此分析回顾了中大西洋地区介入心脏病学经皮导管ASD封堵手术登记处的数据。纳入了美国10家医院的患者。本报告的队列包括68例体重小于8 kg（范围2.3 - 7.8 kg；平均5.5±1.6 kg）、年龄1至24个月（平均8.6±4.7个月）的患者。ASD封堵的适应证为生长发育迟缓、右心明显扩大、其他被认为具有血流动力学意义的分流以及整体临床状况不佳。68例婴儿中有66例成功植入封堵装置（手术成功率97.1%）。发生了5例与手术相关的轻微并发症。在随访评估中，通过体重增加改善以及呼吸机或氧气依赖减少来衡量，临床状况有显著改善。所有残余分流在随访期间均自发闭合。发生了6例晚期死亡，均与封堵装置无明显关联。ASO和GHSO可安全有效地用于体重小于8 kg婴儿的ASD封堵。这些手术通常成功且很少有并发症，从而带来显著的临床改善。
