Transthoracic echocardiography-guided percutaneous intervention for treatment of atrial septal defect complicated with pulmonary valvular stenosis in children

Clinical data of 23 children with atrial septal defect and pulmonary valvular stenosis admitted in Dalian Children′s Hospital during March 2015 to March 2018 were retrospectively analyzed. Twenty patients were treated with percutaneous closure of atrial septal defect through femoral vein first, then transthoracic echocardiography-guided balloon pulmonary valvuloplasty was performed; while 3 patients had no balloon pulmonary valvuloplasty after percutaneous closure of atrial septal defect. Patients were followed up by transthoracic echocardiography and all were doing well. The transvalvular pressure fell under 35 mmHg (1 mmHg=0.133 kPa) [(19.5±1.9)mmHg] in all patients, which was significantly lower than that before treatment [(62.0±7.8 mmHg)] (t=28.92, P<0.01). During follow-up, no residual shunt of atrial septal defect was found; and mild pulmonary regurgitation occurred in 3 cases. The study indicates that combined percutaneous treatment with transthoracic echocardiography guidance is effective and safe for children with atrial septal defect and pulmonary valvular stenosis. The pulmonary artery stenosis of some patients can be alleviated, after closuring of the atrial septal defect.