Headache after transcatheter closure of atrial septal defect: An attempt to explain its origin in pediatric population

Transcatheter closure of atrial septal defect (ASD) has become the treatment of choice for most patients. About 5% of them after the procedure suffer from the transient headache episodes (THE), the etiology of which is unclear.To evaluate risk factors for THE occurrence after transcatheter closure of ASD in the pediatric population.840 patients, after transcatheter ASD closure, with nitinol devices, from a single center, were included in retrospective analysis. THE was defined as occurring up to 24 hours after procedure. A logistic regression model including age, weight, ASD diameter, device size, presence of nitinol coating on device, fluoroscopy time, application of balloon calibration, device oversizing and residual shunt after 24 hours was created to evaluate risk factors for THE occurrence.There were 40 patients (females 70%) with THE (4.8%). Median age was 13 (7.35-16) years. 40 patients (4.8%) with THE. Female 70%, male 30%. Median age 13 (7.35-16) years. Among patients with headache BC was performed more frequently (82.5% vs. 43.3%; P0.001), the balloon waist median (interquartile range [IQR]), 19 (16-22) mm vs. 15 mm (12-18) mm; P P P = 0.03) and a year (7.5 vs. 1.0%; P0.001) was more frequent. ASD size and prevalence of double/multiple ASD were similar in both groups. Age, application of BC, no nickel release protection, duration of fluoroscopy and device oversizing were predictors of THE (P0.001).Balloon calibration during percutaneous ASD closure and absent nickel release protection layer on the device are risk factors of headache occurrence in the early postprocedural period.