Transcatheter Closing Atrial Septal Defect in a Child With Hereditary Spherocytosis

Abstract

A 3-year-old girl was admitted to our hospital for the correction of atrial septal defect (ASD). Open heart operation with cardiopulmonary bypass is dangerous because the patient also had hereditary spherocytosis, which put her at risk for hemolytic anemia. Therefore, percutaneous transcatheter closure for ASD was chosen and performed successfully, which avoided the erythrocyte damage caused by cardiopulmonary bypass. This is the first time such a case has been reported, and we present an alternative approach for ASD with hereditary spherocytosis.

Keywords: atrial septal defect; cardiopulmonary bypass; hemolysis; hereditary spherocytosis; percutaneous transcatheter closure.

Figure 1

High-power view (×100 magnification) of peripheral blood smears from the patient. Spherocytes are indicated by black arrows.

Figure 2

Transcatheter closure of ASD shown by transthoracic color Doppler echocardiography. The apical four-chamber section showed (A) left to right shunt at the level of atrial septum, (B) the continuous interruption of the atrial septum with a loss of about 14 mm, and (C) the atrial septal occluder was well-positioned without residual shunt (see arrow). (D) X-ray examination of left anterior oblique position after interventional closure showed that the occluder was fixed and the shape was normal (see arrow).