Year : 2021 | Volume
: 14 | Issue : 2 | Page : 159--164
Use of cribriform amplatzer septal occluder in the pediatric population: Feasibility, safety, and technical considerations
Priya Pradhan1, Sneha Jain1, Supratim Sen1, Bharat Dalvi2
1 Department of Pediatric Cardiology, NHSRCC Hospital, Mumbai, Maharashtra, India
2 Department of Pediatric Cardiology, NHSRCC Hospital; Glenmark Cardiac Centre, Mumbai, Maharashtra, India
Purpose : Fenestrated atrial septal defects (F-ASDs) in the pediatric population pose a challenge for transcatheter device closure since multiple devices are not preferred in small hearts. Oversizing the Amplatzer Septal Occluder (ASO) to cover the surrounding fenestrations usually distorts the central waist as well as the disc profile and often defeats the purpose. This is a retrospective observational study with an aim to assess the feasibility and safety of cribriform ASO in closing F-ASDs in small children.
Methods : Sixteen children with F-ASD who underwent device closure with cribriform ASO were included in the study. The fenestrated septal length (FSL) and the total septal length (TSL) were measured on transesophageal echocardiogram. A device size which was 1.5–2 times the FSL but smaller than the TSL was selected. The defect was closed with a device passed through a relatively centrally placed smaller fenestration.
Results : The median age of the cohort was 5 years (2.5–10.5). Majority (14/16) required 25 or 30 mm cribriform ASO. Aneurysmal interatrial septum was seen in most of our patients (11/15). All the patients had successful device implantation. Complete closure of the defect was seen in 11 patients while 5 patients had insignificant residual shunt at a median follow-up of 40 months (1–60 months). There were no other complications.
Conclusions : Cribriform ASO can be used safely and effectively in closing F-ASDs in children. Deployment of the device through a small central hole allows covering maximum fenestrations and gives more stability to the device. Residual shunts, although not infrequent, are insignificant.
Dr. Bharat Dalvi
Glenmark Cardiac Centre, 101/102 Swami Krupa Coop Housing Society, D. L Vaidya Marg, Dadar (W), Mumbai - 400 028, Maharashtra
|How to cite this article:|
Pradhan P, Jain S, Sen S, Dalvi B. Use of cribriform amplatzer septal occluder in the pediatric population: Feasibility, safety, and technical considerations.Ann Pediatr Card 2021;14:159-164
|How to cite this URL:|
Pradhan P, Jain S, Sen S, Dalvi B. Use of cribriform amplatzer septal occluder in the pediatric population: Feasibility, safety, and technical considerations. Ann Pediatr Card [serial online] 2021 [cited 2021 Jun 24 ];14:159-164
Available from: https://www.annalspc.com/article.asp?issn=0974-2069;year=2021;volume=14;issue=2;spage=159;epage=164;aulast=Pradhan;type=0