Transcatheter correction of atrial septal defects in children of various age groups, its results, and effects on the right atrium remodelling

Abstract

Aim. The issue of safety and effectiveness of endovascular correction of atrial septal defects (ASD) in children aged 0–3 years remains controversial, due to a range of technical challenges and inadequate knowledge on the right atrium remodeling consequences in children across age groups. We analysed the in-hospital, 30-day, and long-term (12 months) outcomes of transcatheter correction of secundum ASD and occluder implantation in 89 children. Material and methods. All patients were divided into two groups: Group 1 (n=49) – younger children (mean age 1,7±0,6 years) who were operated before the age of 3; and Group 2 (n=40) – older children (mean age 6,2±3,2 years), who underwent the surgery after the age of 3. In both groups, no in-hospital or long-term (12 months) adverse effects, such as death, occluder migration, or the need for open surgery, were registered. Results. By Day 30 after the surgery, both groups demonstrated a consistent, significant reduction in mean size of right atrium, which persisted for the next 12 months (p<0,05). Conclusion. In children aged 0–3 years, endovascular correction of ASD is safe and effective. It is also beneficial in terms of right atrium remodelling effects, both in younger children (mean age 1,7±0,6 years) and in older children (mean age 6,2±3,2 years).