Transcatheter atrial septal defect closure in an infant (body weight 6.4  kg) using the GORE CARDIOFORM septal occluder (GCSO)

We report on a 10-month-old infant, body weight of 6.4  kg, with a large ASD who was referred for failure to thrive and dyspnea on exertion. Echocardiography showed two neighboring ASDs centrally located within an atrial septum with a length of 27 mm resulting in significant left-to-right shunting. During cardiac catheterization, hemodynamic significa nce of the defect as well as normal pulmonary vascular resistance was demonstrated. Balloon sizing of the central ASD showed a stretched defect diameter of 12 × 11 mm. A 20-mm GORE CARDIOFORM septal occluder (GCSO; Goremedical, W. L. Gore& Associates, Inc., Newark, DE, USA) was implanted without any complications. Initial trivial residual shunting resolved during 4  months of follow-up. Right ventricular dimensions declined significantly, and the boy gained body weight properly.Discussion, evaluation and conclusionAs demonstrated in our report, even large ASDs can be closed safely by catheter intervention in small infants. Selection of implant device and optimal sizing is of paramount importance. The size of the delivery sheath (11 French  in our patient) is a potential limitation for the GCSO in smaller infants.
Source: Molecular and Cellular Pediatrics - Category: Cytology Source Type: research