Early and mid-term results of transcatheter closure of perimembranous ventricular septal defect using Amplatzer Ductal Occluder type 1
DOI:
https://doi.org/10.22317/imj.v6i2.1176Keywords:
Transcatheter closure, Perimembranous Ventricular Septal Defect, Amplatzer Ductal Occluder Type 1Abstract
Objectives: To study the early and midterm results of transcatheter closure of perimembranous VSD using Amplatzer Ductal Occluder type 1.
Methods: Prospective study of one hundred thirteen patients with perimembranous VSD (PMVSD) who referred to catheterization laboratory and underwent transcatheter closure of their defects by using Amplatzer Ductal Occluder type 1 device. Routine right and left heart catheterization was performed with evaluation of the pulmonary and systemic pressure. All the procedures were done under fluoroscopy and transthoracic echocardiography guide. Follow up evaluations were done between 1 month and 12 months after discharge (mean 4.5 ± 1.13 months) with transthoracic echocardiography and 12 lead electrocardiography.
Results: The age of patients range from 2 to 34 years at procedure (mean 10.60 ± 7.31 years), weight range from 10 to 85 kg (mean 32.38 ± 19.70 kg). The mean echocardiographic defect size was 5.69 ± 1.63 mm and the mean angiographic size was 5.89 ± 1.70 mm. The devices size used range from 6/4 – 16/14 mm. The most common device used was 10/8. The ADOs were successfully implanted in 108 patients (95.6 %). The VSD occlusion rate was 85.2% at completion of the procedure, rising up to 90.7 % next day at discharge, 93.5% at one month and 97.2% at 6 months during follow-up. Two patients (1.9%) developed CAVB, one case within 24 hours and the other case after 2 days of the procedure, they were admitted in hospital treated by temporary pacemaker implantation, steroids and NSAIDs (high dose aspirin) with complete remission within 5 days. Conclusion: Transcatheter closure of PMVSD with ADO1 in children is a safe and effective treatment associated with excellent success and closure rates and with no significant adverse events, but long-term follow-up in a large number of patients would be warranted.
References
Nadas AS, Fyler DC. Pediatric Cardiology. 3rd ed. Philadelphia: WB Saunders, 1972:348.
Minette MS, Sahn DJ; Ventricular septal defects. Circulation. 2006 Nov 14;114(20):2190-7.
Beke A, Papp C, Toth-Pal E, et al; Trisomies and other chromosome abnormalities detected after positive sonographic findings. J Reprod Med. 2005 Sep;50(9):675-91.
Loffredo CA, Hirata J, Wilson PD, et al; Atrioventricular septal defects: possible etiologic differences between complete and partial defects. Teratology. 2001 Feb;63(2):87-93.
Steeg CN, Woolf P; Cardiovascular malformations in the fetal alcohol syndrome. Am Heart J. 1979 Nov;98(5):635-7.
Williams LJ, Correa A, Rasmussen S; Maternal lifestyle factors and risk for ventricular septal defects. Birth Defects Res A Clin Mol Teratol. 2004 Feb;70(2):59-64.
Turner SW, Hunter S, Wyllie JP; The natural history of ventricular septal defects. Arch Dis Child. 1999 Nov;81(5):413-6.
Bol-Raap, G., Weerheim, J., Kappetein, A.P., Witsenburg, M. and Bogers, A.J. (2003) Follow-up after surgical closure of congenital ventricular septal defects. European Journal Cardio-Thoracic Surgery, 24, 511-515.
Mavroudis C, Backer CL, Jacobs JP. Pediatric Cardiac Surgery. 3 rd. Mosby, Inc; 2003. Ventricular septal defect; p. 298-320.
Bian, C., Ma, J., Wang, J., Xu, G., Jiang, J., Yao, S. and Liu, Y. (2011) Perimembranous ventricular septal defect with aneurysm: Two options for transcatheter closure. Texas Heart Institute Journal, 38, 528-532.
Catheter Cardiovasc interv. 2013 Dec 1;82(7):1141-6 Doi:10.1002/ccd.24810. Epub 2013 Aug 20.
Iran J Pediatr. 2015 Apr; 25(2): e386. doi: 10.5812/ijp.386. Epub 2015 Apr 18.
Butera, G., Carminati, M., Chessa, M., Piazza, L., Micheletti, A., Negura, D.G., Abella, R., Giamberti, A. and Frigiola, A. (2007) Transcatheter closure of perimembranous ventricular septal defects: Early and long-term results. Journal of the American College of Cardiology, 50, 1189. doi:10.1016/j.jacc.2007.03.068
Nguyen Lan Hieu, Transcatheter closure of ventricular septal defect using duct occluder device. Hnoi Medical University, Vietnam Heart Institute (2010).
El Said HG, Bratincsak A, Gordon BM, et al. Closure of perimembranous ventricular septal defects using the Amplazter Duct Occluder I: lessons learned and medium term follow up. Catheter Cardiovasc Interv. 2012;80:895–903.
Mohammad Y, Merajie M, Mortezaeian H, Aarabi M, Ghaderian M, Shah Mohammadi A, Iran J Pediatr.2015 Apr;25(2):e386. Doi: 10.5812/ijp.386. Epub 2015 Apr 18.
Mahimarangaiah J, Subramanian A, Kikkeri Hemannasetty S, Chandra S, Karur S, Mandikal Kodandaramasastry U, Cholenahally Nanjappa M. Cardiol Young. 2015 Jun;25(5):918-26. Doi: 10.1017/S1047951114001255. Epub 2014 Jul 15.
Shah SMA, Ikramullah, Khan MG, Naseemullah, Malik A, Khan RA. Frequency of complete heart block after surgical closure of perimembranous ventricular septal defect. J Postgrad Med Inst 2015; 29(4): 308-12.
Ralf Holzer, MD, David Balzer, MD, FACC, Qi-Ling Cao, MD, Ken Lock, BS,Ziyad M. Hijazi, MD, MPH, FACC, for the Amplatzer Muscular Ventricular Septal Defect Investigators. The American Journal of Cardiology volume43 NO 7.April 2004,1257–63.
Ghaderian M, Meraji M, Aarabi M, Shah Mohammadi A, Iran J Pediatr. 2015 Apr; 25(2): e386. doi: 10.5812/ijp.386. Epub 2015 Apr 18.
Bol-raap g, weerheim j, kappetein ap, witsenburg m, bogers aj: follow-up after surgical closure of congenital ventricular septal defect. eur j cardiothorac surg 2003, 24(4):511-515.