Author + information
- Received December 18, 2017
- Revision received January 16, 2018
- Accepted January 23, 2018
- Published online April 16, 2018.
- Zakaria Jalal, MDa,b,c,∗ (, )
- Sébastien Hascoët, MDd,e,
- Céline Gronier, MDf,
- François Godart, MD, PhDg,
- Lucia Mauri, MDd,
- Claire Dauphin, MDh,
- Bruno Lefort, MDi,
- Matthias Lachaud, MDj,
- Dominique Piot, MDd,
- Marie-Lou Dinet, MDa,
- Yael Levy, MDa,
- Alain Fraisse, MD, PhDk,
- Caroline Ovaert, MD, PhDk,
- Xavier Pillois, PhDb,
- Jean-René Lusson, MD, PhDh,
- Jérôme Petit, MDd,
- Alban-Elouen Baruteau, MD, PhDl and
- Jean-Benoit Thambo, MD, PhDa,b,c
- aBordeaux University Hospital (CHU), Department of Paediatric and Adult Congenital Cardiology, Pessac, France
- bIHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France
- cINSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux, France
- dM3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery Department, Paris Sud University, Plessis-Robinson, France
- eDepartment of Paediatric Cardiology, Hopital des Enfants, Paul-Sabatier University, CHU de Toulouse, Toulouse, France
- fCabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte, Strasbourg, France
- gCHRU de Lille, University Lille Nord-de-France, Faculté de Médecine, Hôpital Cardiologique, Service des Maladies Cardiovasculaires Infantiles et Congénitales, Lille, France
- hService de Cardiologie et Maladies Cardiovasculaires, Hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
- iUnité de Cardiologie Pédiatrique, Hôpital des Enfants Gatien de Clocheville, INSERM UMR 1069 et Université François Rabelais, Tours, France
- jInserm UMR 1087—CNRS UMR6291, Institut du Thorax, Nantes University, Nantes, France
- kPaediatric and Congenital Cardiology, La Timone Hospital, M3C CHU de Marseille, Marseille, France
- lDepartment of Congenital Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- ↵∗Address for correspondence:
Dr. Zakaria Jalal, University Hospital of Bordeaux, Avenue Magellan, 33600 Pessac, France.
Objectives This study sought to assess procedural characteristics, early clinical outcome, and long-term complications after transcatheter closure of atrial septal defect (ASD) in children.
Background Transcatheter closure has become the preferred strategy in most cases of isolated secundum ASD. However, reported experience in the pediatric population is limited.
Methods A 1998 to 2016 retrospective multicenter study was performed in 9 French tertiary institutions. All children who had an attempt of percutaneous ASD closure with an Amplatzer Septal Occluder were included.
Results In 1,326 children (39% males; median age, 9 years [0.7 to 18]; weight, 29 kg [3.6 to 92]), transcatheter ASD closure was performed. Median ASD size was 15 mm (3 to 41); 254 (19.1%) patients had a large ASD (≥20 mm/m2). Procedural success rate was 95.3% (95% confidence interval: 93.9% to 96.3%). No death was observed but periprocedural complications occurred in 24 patients (1.8%). After a median follow-up of 3.5 years (range 6 months to 18 years; 173 patients [13%] followed >10 years), delayed major complications were minimal (n = 12; 1.04%) including no death and/or cardiac erosion. Periprocedural and delayed complications rates were significantly higher in children ≤15 kg (5.2% vs. 1.5%; p = 0.007 and 3.1% vs. 0.7%; p < 0.007, respectively) and those with large ASD (3.5% vs. 1.4%; p = 0.008 and 1.7% vs. 0.7%; p = 0.052, respectively).
Conclusions Transcatheter ASD closure using Amplatzer Septal Occluder is safe in children with a minimal rate of periprocedural complications and a favorable long-term outcome, especially with no death or cardiac erosion despite a substantial proportion of large defects. Children ≤15 kg and those with large ASDs had a greater risk of complications.
This study was supported by the French Government as part of the Investments of the Future program managed by the National Research Agency (ANR-10-IAHU-04). Dr. Baruteau was supported by a research grant from the French Federation of Cardiology. Drs. Jalal and Baruteau have received a research grant from St. Jude Medical. Dr. Hascoët has received consulting fees from Abbott. Dr. Fraisse is a proctor for Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Baruteau and Thambo contributed equally to this work.
- Received December 18, 2017.
- Revision received January 16, 2018.
- Accepted January 23, 2018.
- 2018 American College of Cardiology Foundation