Utku PAMUK, Hazım Alper GÜRSU, Emine AZAK, Yasemin Özdemir ŞAHAN, İbrahim İlker ÇETİN
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(4):226-230
Objective: The aim of this study was to assess the feasibility, safety, and outcomes of transcatheter atrial septal defect (ASD) closure in children weighing <=15 kg, a group in whom transcatheter intervention is often deferred due to limited evidence and perceived procedural risks. Materials and Methods: This retrospective single-center study included 34 children weighing <=15 kg who underwent transcatheter ASD closure. Demographic, echocardiographic, procedural, and post-procedural follow-up data were analyzed. Results: The mean age was 4.14+/-1.16 years, and the mean ASD diameter on transthoracic echocardiography was 10.41+/- 2.96 mm. The median balloon-sized ASD diameter was 14.30 mm (IQR: 12-17). All procedures were performed using Amplatzer Septal Occluder devices, with a 100% procedural success rate. The mean pulmonary artery pressure was 19.50+/-5.01 mmHg, and median pulmonary vascular resistance was 0.97 Wood units (0.44-1.20). A transient episode of supraventricular tachycardia occurred in one patient (2.94%), with no device embolization or other major complications observed. In most patients, right ventricular dimensions normalized and no residual shunt was observed by the first postoperative day. Conclusion: Transcatheter ASD closure in carefully selected children weighing <=15 kg appears to be a safe and effective procedure, achieving high procedural success and low complication rates comparable to those observed in heavier patients. Early right ventricular remodeling and the absence of major adverse events further support the feasibility of this approach in appropriately selected cases.
