Transcatheter closure of atrial septal defects without fluoroscopy: a well-established procedure for alternative use in children.

AIMS

The feasibility of transcatheter closure of atrial septal defects (ASD) without fluoroscopy has been proven. However, the technique has not been accepted for routine use. We report our experience with trans-catheter closure of ASD without fluoroscopy and introduce a well-established technique for alternative use in children.

METHODS AND RESULTS

From November 2013 to May 2015, a total of 114 children with isolated secundum ASD (diameter 6 mm to 24 mm, median 13.8 mm) underwent attempted transcatheter device closure under the guidance of transoesophageal echocardiography without fluoroscopy. Using a modified delivery system and procedure technique, ASD were successfully closed in 110 patients (96.5%, 52 males, 58 females, aged from three to 14 years, median 5.4 years, weight 12 to 46 kg, median 23.5 kg). Procedure time ranged from eight to 42 minutes (median 18 min). Three patients underwent percardiac device closure after failed procedures. In the early stage of our study, before delivery system and technique modification, one patient was converted to open heart surgery due to rupture of the left appendage. No intervention-related complications were detected during a median follow-up of nine months.

CONCLUSIONS

Using a modified delivery system and a re-established procedure, we showed that transcatheter closure of ASD without fluoroscopy is a safe technique for alternative use in children.