Abstract
IntroductionTranscatheter closure has become the treatment of choice for secundum atrial septal defects (ASD II), but particularly in small children, there is concern regarding procedure-related complications.Case descriptionWe report on a 10-month-old infant, body weight of 6.4 kg, with a large ASD who was referred for failure to thrive and dyspnea on exertion. Echocardiography showed two neighboring ASDs centrally located within an atrial septum with a length of 27 mm resulting in significant left-to-right shunting. During cardiac catheterization, hemodynamic significance of the defect as well as normal pulmonary vascular resistance was demonstrated. Balloon sizing of the central ASD showed a stretched defect diameter of 12 × 11 mm. A 20-mm GORE CARDIOFORM septal occluder (GCSO; Goremedical, W. L. Gore & Associates, Inc., Newark, DE, USA) was implanted without any complications. Initial trivial residual shunting resolved during 4 months of follow-up. Right ventricular dimensions declined significantly, and the boy gained body weight properly.Discussion, evaluation and conclusionAs demonstrated in our report, even large ASDs can be closed safely by catheter intervention in small infants. Selection of implant device and optimal sizing is of paramount importance. The size of the delivery sheath (11 French in our patient) is a potential limitation for the GCSO in smaller infants.
Highlights
Transcatheter closure has become the treatment of choice for secundum atrial septal defects (ASD II), but in small children, there is concern regarding procedure-related complications.Case description: We report on a 10-month-old infant, body weight of 6.4 kg, with a large Atrial septal defect (ASD) who was referred for failure to thrive and dyspnea on exertion
A wide range of occlusion devices is available, but concern has been raised about procedure-related adverse events, especially cardiac erosion and vascular damage, with an increased risk in small patients [1]
Case description We report the case of an infant with Down’s syndrome who underwent transcatheter ASD closure using the GORE CARDIOFORM septal occluder (GCSO) with 6.4 kg body weight
Summary
Transcatheter closure has become the treatment of choice for secundum atrial septal defects. Echocardiography showed two neighboring ASDs centrally located within the atrial septum with a length of 27 mm resulting in significant left-to-right shunting, significant right heart enlargement, and functional pulmonary stenosis. Due to persistent failure to thrive at 10 months of age, the baby underwent cardiac catheterization under general anesthesia. No procedure-related complications were documented by follow-up routine diagnostic examinations (electrocardiogram, transthoracic echocardiography and duplexsonography of femoral veins), no electrocardiographic alterations, cardiac erosion, pericardial effusion, or vascular damage at the access site. Correct position of the device and initial residual shunting was documented by routine transthoracic echocardiography. Four months after interventional closure, no residual shunt was detectable by transthoracic echocardiography
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call