Results of endovascular correction of atrial septal defect in preschool children

Objective: analysis of longterm outcomes (12 months) of the atrial septal defect (ASD) occluder implantation in children of different preschool age. 55 children (age 1-6) underwent endovascular ASD correction with occlusion implant. Patients were divided into two groups: group 1 (n=31) comprised patients of early age (mean age 1.67±0.50 years) who underwent intervention during the first three years of life; group 2 (n=24) included older pediatric patients (mean preschool age 4.16±1.05 years) who were considered optimal for ASD correction. Most of patients in both groups were female (63% and 58% for groups 1 and 2, respectively; p>0.05). The groups were similar in regard to ASD size (average diameter of 8.40±2.80 mm versus 8.70±2.03 mm in group 1 and 2, respectively) and average occlusion implant diameter (average diameter of 10.56±2.11 mm versus 11.46±1.70 mm, respectively, p>0,05). The group 1 received occlusion implant without preliminary sizingballoon maneuver. Immediate success of the intervention (no hemodynamically significant blood shunting and no complications with the complete closure of residual ASD shunt in the longterm) was found in 100% cases in both groups. During following 12 months, there were no deaths or complications such as implant migration or need for an openheart thoracic surgery in either group. According to the echocardiography data, the rate of patients with right ventricular dilatation decreased from initial 81% (n=25) to 42% (n=13) in the group of younger patients to the 30th day after intervention; p0.05). 12 months after intervention, stable decrease in average right atrial size was found in group 1 (from initial 26.0±4.6 mm to 23.8±3.0 mm; p0.05).