IntroductionTranscatheter closure has become the treatment of choice for secundum atrial septal defects (ASD II), but particularly in small children, there is concern regarding procedure-related complications.Case descriptionWe 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 significance 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.

中文翻译：

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使用 GORE CARDIOFORM 室间隔封堵器 (GCSO) 对婴儿（体重 6.4 公斤）进行经导管房间隔缺损封堵术

介绍经导管封堵术已成为继发孔型房间隔缺损 (ASD II) 的首选治疗方法，但特别是在小儿童中，存在手术相关并发症的担忧。案例描述我们报告了一名 10 个月大的婴儿，体重为 6.4 kg ，患有大型 ASD，因无法茁壮成长和劳累呼吸困难而被转诊。超声心动图显示两个相邻的 ASD 位于房间隔中央，长度为 27 毫米，导致显着的左向右分流。在心导管术期间，证明了缺陷的血流动力学意义以及正常的肺血管阻力。中央 ASD 的球囊尺寸显示拉伸缺陷直径为 12 × 11 mm。20 毫米 GORE CARDIOFORM 隔膜封堵器 (GCSO; Goremedical, WL Gore & Associates, Inc., Newark, DE, USA) 的植入没有任何并发​​症。最初的微不足道的残余分流在 4 个月的随访中得到解决。右心室尺寸显着下降，男孩体重适当增加。讨论、评估和结论正如我们的报告所证明的那样，即使是大的 ASD 也可以通过导管干预对小婴儿安全地关闭。选择植入装置和最佳尺寸至关重要。分娩鞘的尺寸（我们患者为 11 法式）是小婴儿 GCSO 的潜在限制。即使是大型 ASD 也可以通过对小婴儿进行导管干预来安全关闭。选择植入装置和最佳尺寸至关重要。分娩鞘的尺寸（我们患者为 11 法式）是小婴儿 GCSO 的潜在限制。即使是大型 ASD 也可以通过对小婴儿进行导管干预来安全关闭。选择植入装置和最佳尺寸至关重要。分娩鞘的尺寸（我们患者为 11 法式）是小婴儿 GCSO 的潜在限制。