{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:29:34Z","timestamp":1785115774070,"version":"3.55.0"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T00:00:00Z","timestamp":1673136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The Atrial Flow Regulator (AFR) is a new self\u2010expandable percutaneous\u2010delivered fenestrated device providing an interatrial shunt. Its use in pediatric population has been reported in failing Fontan, pulmonary hypertension, or in patients with cardiomyopathy and venoarterial extracorporeal membrane oxygenator (ECMO) support. Its use in small children under 10\u2009kg has not been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We report the initial single center experience of the AFR implantation in children below 10\u2009kg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four children underwent AFR implantation. Patients' age and weight ranged between 9 and 22 months and 5\u22128.7\u2009kgs. Indications were to unload the left atrium during ECMO support for end\u2010stage cardiomyopathy and to enlarge a restrictive interatrial shunt in two other patients with complex congenital heart diseases. Devices implanted were AFR\u20106 and AFR\u20108. Delivery sheaths used via venous femoral access were undersized and ranged from 9 to 11\u2009Fr. Devices were successfully implanted and provided unrestrictive interatrial shunt in all cases. One child developed a nonocclusive thrombus in the inferior vena cava which resolved within 1 month. Clinical improvement and femoral vein patency were observed in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AFR implantation is feasible in selected children under 10\u2009kg. The AFR can be safely deployed through sheaths that are 1\u22122\u2009Fr smaller than the recommended manufacturer size. More studies are needed to confirm safety and efficacy of the device in selected pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30536","type":"journal-article","created":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T17:19:21Z","timestamp":1673198361000},"page":"396-400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Feasibility, safety, and efficacy of Atrial Flow Regulator in children under 10\u2009kg"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4946-9219","authenticated-orcid":false,"given":"Carles","family":"Bautista\u2010Rodriguez","sequence":"first","affiliation":[{"name":"Pediatric Cardiology Services, Royal Brompton Hospital Guy's &amp; St Thomas' Foundation Trust  London UK"},{"name":"National Heart and Lung Institute Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8695-0503","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Hasco\u00ebt","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Diseases, Centre de Re\u0301fe\u0301rence Malformations Cardiaques Conge\u0301nitales Complexes M3C, Ho\u0302pital Marie Lannelongue Groupe Hospitalier Paris\u2010Saint Joseph  Paris France"},{"name":"UMR\u2010S 999, Inserm, Ho\u0302pital Marie Lannelongue, Faculte\u0301 de Me\u0301decine Paris\u2010Saclay Universite\u0301 Paris\u2010Saclay  Plessis\u2010Robinson France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1969-421X","authenticated-orcid":false,"given":"Alain","family":"Fraisse","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Services, Royal Brompton Hospital Guy's &amp; St Thomas' Foundation Trust  London UK"},{"name":"National Heart and Lung Institute Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00342"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2119"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJY15M07_08"},{"issue":"5","key":"e_1_2_8_5_1","article-title":"The creation of an interatrial Right\u2010To\u2010Left shunt in patients with severe, irreversible pulmonary hypertension: rationale, devices, outcomes","volume":"21","author":"Lehner A","journal-title":"Curr Cardiol Rep [Internet]"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivy165"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951118000720"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29590"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27233"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2020.11.006"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27462"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753944720919577"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-006-1325-0"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.2019.0016"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.10.020"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30536","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.30536","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T12:10:36Z","timestamp":1692360636000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.30536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,8]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1002\/ccd.30536"],"URL":"https:\/\/doi.org\/10.1002\/ccd.30536","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,8]]},"assertion":[{"value":"2022-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}