Atrial septal defect (ASD)

Atrial sepal defect (ASD) constitutes 8%–10% of the congenital heart defects in children. The secundum ASD accounts for nearly 75% of all ASDs. Since the introduction of transcatheter device closure for secundum ASDs  there has been a paradigm shift in their management. Over the years, the procedure has evolved significantly to become a treatment of choice in many institutions.

The Amplatzer septal occluder (ASO) is the most widely used device owing to its user-friendliness and high success rate. You can submit here any of the related topic to Insights in Pediatric cardiology.

However, most of these studies have included bigger children, adolescents, and adults. Although a few studies have demonstrated the feasibility and reasonable safety of transcatheter ASD device closure in very young children none of them have addressed important issues like how large a defect is too large for device closure, how to select the size of the device, does the length of the interatrial septum (IAS) matter in the device selection, and is there a need for using modified techniques to achieve successful deployment of the device in this subset of patients which is characterized by relatively large defects in small hearts.

ASD device closure is routinely done in the preschool going age of around 4 years with children weighing about 15 kg. However, in this study, the mean age (25.71 months) and weight (8.99 kg) were much less in view of the symptomatic status of these children with or without elevation of the pulmonary arterial pressures (PAP).

Recent studies have adequately documented the feasibility of device placement in this subset, but the complication rate has been significant, especially in those who were small and very sick due to bronchopulmonary dysplasia.

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