Department of Pediatric Cardiology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India.
Department of Pediatric Intensive Care, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India.
Cardiol Young. 2022 Jan;32(1):48-54. doi: 10.1017/S1047951121001578. Epub 2021 May 17.
To assess the feasibility of percutaneous transcatheter device closure of ventricular septal defects in children weighing less than 10 kg.
Although percutaneous transcatheter device closure of ventricular septal defect is a well-established method of treatment in older children and adolescents, there is limited data on device closure in small children weighing less than 10 kg. We present our institutional experience of transcatheter VSD closure in children weighing less than 10 kg.
Medical records were reviewed for 16 children, who were selected for device closure of ventricular septal defects based on the inclusion criteria.
Out of 65 patients with a diagnosis of ventricular septal defect, 16 children less than 10 kg were attempted for percutaneous device closure. In 13 patients, the device was successfully released, and 3 patients needed surgical closure of the defect. Mean age and weight of the patients were 17.3 ± 12.7 months and 6.8 ± 3.2 kg, respectively. Mean defect size was 6 mm (range 3-10). There was no incidence of device embolisation or heart block or death. Five patients had residual left-to-right shunt immediately after the device release, which got closed by the first month's follow-up. We had one accidental perforation of right ventricular free wall at the time of crossing of the defect, which was successfully repaired surgically.
Percutaneous device closure of ventricular septal defect in small children with weight below 10 kg is feasible with good short-term outcome. Careful patient selection is essential for procedural success and to avoid complications.
评估体重小于 10 公斤的儿童行经皮导管装置关闭室间隔缺损的可行性。
虽然经皮导管装置关闭室间隔缺损在较大的儿童和青少年中是一种成熟的治疗方法,但对于体重小于 10 公斤的小儿童,关于装置关闭的数据有限。我们介绍了我们机构在体重小于 10 公斤的儿童中经导管 VSD 关闭的经验。
回顾了 16 名儿童的病历,这些儿童根据纳入标准选择进行室间隔缺损的装置关闭。
在 65 例诊断为室间隔缺损的患者中,有 16 例体重小于 10 公斤的儿童尝试了经皮装置关闭。在 13 例患者中,装置成功释放,3 例患者需要手术关闭缺损。患者的平均年龄和体重分别为 17.3±12.7 个月和 6.8±3.2 公斤,平均缺损大小为 6 毫米(范围 3-10)。没有发生装置栓塞、心脏传导阻滞或死亡。5 例患者在装置释放后立即出现残余左向右分流,在第一个月的随访中关闭。我们在穿过缺损时意外地在右心室游离壁穿孔一处,通过手术成功修复。
体重低于 10 公斤的小儿童经皮导管装置关闭室间隔缺损是可行的,短期结果良好。仔细选择患者对于手术成功和避免并发症至关重要。