{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T11:15:53Z","timestamp":1767093353716},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,11,14]],"date-time":"2012-11-14T00:00:00Z","timestamp":1352851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:p><jats:styled-content>Objectives<\/jats:styled-content>: To evaluate feasibility, efficacy, and safety of an approach to atrial septal defect (ASD) occlusion in children \u226420 kg that eliminates cardiac wall erosion risk. <jats:styled-content>Background<\/jats:styled-content>: Cardiac wall erosion is a potentially catastrophic complication of ASD device closure. The HELEX Septal Occluder (HSO) is a compliant device with no reports of erosion. The HSO is technically difficult to deploy in smaller children and cannot be used to close larger defects. To eliminate wall erosion risk, we use the HSO when feasible and surgery for larger defects. <jats:styled-content>Methods<\/jats:styled-content>: Retrospective review of ASD procedures performed in children \u226420 kg. <jats:styled-content>Results<\/jats:styled-content>: Between January 2006 and January 2011, 60 children underwent ASD closure. HSO placement was successful in 32 of 34 patients, and surgical closure was successful in all of 28 patients. Surgical patients were younger (35.1 \u00b1 12.6 vs. 47.4 \u00b1 15.3 months, <jats:italic>P<\/jats:italic> &lt; 0.01) and smaller (15.3 \u00b1 3.2 vs. 12.6 \u00b1 4.3 kg; <jats:italic>P<\/jats:italic> &lt; 0.01) with larger ASDs (15.8 \u00b1 4.5 vs. 9.8 \u00b1 3.0 mm; <jats:italic>P<\/jats:italic> &lt; 0.01). No surgical patients demonstrated residual leak. Residual leak was seen in 14 of 32 (44%) HSO patients on postprocedure day #1 and in 1 of 26 (3.8%) with \u22656 months follow\u2010up. Indications for surgery included: deficient inferior\/superior rims (<jats:italic>n<\/jats:italic> = 17), provider preference (<jats:italic>n<\/jats:italic> = 2), and HSO device not feasible (<jats:italic>n<\/jats:italic> = 9). Serious adverse events included device embolization with percutaneous retrieval (<jats:italic>n<\/jats:italic> = 1) and postpericardiotomy syndrome without intervention (<jats:italic>n<\/jats:italic> = 1). <jats:styled-content>Conclusions<\/jats:styled-content>: The HSO can be safely used in most children \u226420 kg. Our approach to ASD closure is associated with minimal morbidity and good short\u2010term results. This approach requires no more than a 15% increase in surgical referrals and eliminates risk of cardiac wall erosion. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ccd.24500","type":"journal-article","created":{"date-parts":[[2012,5,28]],"date-time":"2012-05-28T09:37:33Z","timestamp":1338197853000},"page":"654-659","source":"Crossref","is-referenced-by-count":4,"title":["A strategy for atrial septal defect closure in small children that eliminates long\u2010term wall erosion risk"],"prefix":"10.1002","volume":"81","author":[{"given":"Kevin D.","family":"Hill","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Lodge","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Forsha","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory A.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda S.","family":"Green","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F.","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,11,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21030"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.06.018"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21450"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2011.00540.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.06.013"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.12.021"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21931"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20211"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2007.00107.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.02.032"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.12.072"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.01.005"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21929"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc3301.092792"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.03.001"},{"key":"e_1_2_6_17_1","unstructured":"http:\/\/www.sjmprofessional.com\/Resources\/instructions\u2010for\u2010use\/amplatzer\u2010septal\u2010occluder\u2010us.aspx. 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