Percutaneous Closure of Atrial Septal Defect Under the Guidance of Complete Transthoracic Ultrasound in Infants Under 10kg

Background: This study attempts to discuss the efficacy and safety of transthoracic echocardiogram (TTE) -guided percutaneous atrial septal defect (ASD) closure for infants under 10 Kg. Methods: This is a retrospective study involving 37 infants who received TTE-guided percutaneous ASD closure at our hospital from September 2014 to September 2020. There were 22 girls and 15 boys. The age and weight were respectively between 3-18 m (9.05±3.67, 95% CI 7.83–10.28 m) and 3.50-9.80 Kg (7.58±1.43, 95% CI 7.11–8.06 Kg). Symptoms were recurrent pneumonia in 29 cases, evidence of dysplasia in 22 cases, and pulmonary arterial hypertension in 12 cases. Right atrial and ventricular dilation were present in all the 37 cases of varying degrees. Intubation was applied to all cases under general anesthesia, followed by TTE-guided percutaneous ASD closure via the femoral vein approach. Results: The overall success rate was 94.59% (35/37). Postoperative TTE showed that the size of the right atrium and right ventricle was significantly decreased than preoperative baseline data (p<0.05). There were no deaths or any serious complications during the perioperative period. At follow-up (6-72 m), there was no death and other complication. Nineteen cases with development dysplasia (19/22, 86.36%) had recovered height and weight equivalent to peer infants, 21 cases with respiratory system symptoms (21/29, 72.41%) got improved symptoms and all 12 cases with pulmonary arterial hypertension (100%) recovered to normal. Conclusions: This study applied TTE-guided percutaneous ASD closure for infants under 10 Kg with appreciating efficacy and a safety profile.