Closure of perimembranous ventricular septal defects with aneurysmal tissue using the amplazter duct occluder I: Lessons learned and medium term follow up

2012 ◽  
Vol 80 (6) ◽  
pp. 895-903 ◽  
Author(s):  
Howaida G. El Said ◽  
Andras Bratincsak ◽  
Brent M. Gordon ◽  
John W. Moore
Author(s):  
Anh Binh Ho

Transcatheter closure of perimembranous and muscular ventricular septal defects: short and medium-term outcome ABSTRACT Objective: This study attempted to report the initial results: the safety and efficacy of transcatheter closure of ventricular septal defects (VSDs) at Hue Central Hospital with the short and medium-term follow-up. Methods: From September 2012 to May 2017, a total of 36 patients with perimembranous or muscular VSD underwent an attempt of transcatheter closure at the Department of Interventional Cardiology, Hue Central Hospital. Results: 14 males and 26 females participated in this study, with the age of 17,29  13.72 and 24.23  12.32 respectively. Among these patients, 19.44% of them were under 6-year-old; 72.22% had perimembranous VSDs, 27.78% had muscular VSDs, and 33.33% had aneurysm. The distance to AV was 5.62 ± 4.32 mm. The device size was 15.31± 8.12 mm. Procedures lasted for 57.17 ± 26.5 min with 15.31± 8.12 min of exposure. The complete closure rates by transthoracic echocardiography after 24 hours, 1 month, 3 months and 6 months (transthoracic) were 94.44%; 94.44% ; 97.22% and 100%, respectively. Mean time of follow-up was 11.92 ± 8.36 (3-38) months. Success rate was 97.22% and no death occurred. There was 1 case of hematuria, lasting 1 month; no Atrioventricular (AV) block. Conclusions: Transcatheter closure of VSDs is a novel, feasible and safe technique with high success rate (97.22%). The transcather approach provides a less invasive alternative than surgical closure and might become the first choice treatment in selected patients. Key words: transcatheter closure, ventricular septal defects


2020 ◽  
Author(s):  
Long Wang ◽  
Lin Xie ◽  
Weiqiang Ruan ◽  
Tao Li ◽  
Changping Gan ◽  
...  

Abstract Background: This report presents updated data and mid-term follow-up information to a former study introducing the novel technique of percutaneous-perventricular device closure of doubly committed subarterial ventricular septal defect. Methods: Thirty-eight patients were added to the former series. There were 54 patients in total who had isolated doubly committed subarterial ventricular septal defects and underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5-year follow-up. Results: Surgery was successful in 53 patients (98.1%). There was no death, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient developed pericardial effusion and tamponade in the former series. The mean hospital stay was 3.2±0.6 days (range, 3.0 to 6.0 days), and only one unsuccessful case needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be safe. Close monitoring for bleeding is essential postoperatively, especially in younger patients. This technique is generally safe with acceptable mid-term follow-up.


2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Marie Maagaard ◽  
Filip Eckerström ◽  
Nicolai Boutrup ◽  
Vibeke E. Hjortdal

Background Ventricular septal defects (VSD), when treated correctly in childhood, are considered to have great prognoses, and the majority of patients are discharged from follow‐up when entering their teens. Young adults were previously found to have poorer functional capacity than healthy peers, but the question remains whether functional capacity degenerates further with age. Methods and Results A group of 30 patients with surgically closed VSDs (51±8 years) with 30 matched, healthy control participants (52±9 years) and a group of 30 patients with small unrepaired VSDs (55±12 years) and 30 matched control participants (55±10 years) underwent cardiopulmonary exercise testing using an incremental workload protocol and noninvasive gas measurement. Peak oxygen uptake was lower in participants with closed VSDs than matched controls (24±7 versus 34±9 mL/min per kg, P <0.01) and with unrepaired VSDs than matched controls (26±5 versus 32±8 mL/min per kg, P <0.01). Patients demonstrated lower oxygen uptake from exercise levels at 20% of maximal workload compared with respective control groups ( P <0.01). Peak ventilation was lower in patients with surgically closed VSDs than control participants (1.0±0.3 versus 1.4±0.4 L/min per kg, P <0.01) but similar in patients with unrepaired VSDs and control participants ( P =0.14). Exercise capacity was 29% lower in older patients with surgically closed VSDs than healthy peers, whereas younger patients with surgically closed VSDs previously demonstrated 18% lower capacity compared with peers. Older patients with unrepaired VSDs reached 21% lower exercise capacity, whereas younger patients with unrepaired VSDs previously demonstrated 17% lower oxygen uptake than healthy peers. Conclusions Patients with VSDs demonstrate poorer exercise capacity than healthy peers. The difference between patients and control participants increased with advancing age—and increased most in patients with operated VSDs—compared with previous findings in younger patients. Results warrant continuous follow‐up for these simple defects.


2019 ◽  
Vol 27 (7) ◽  
pp. 529-534
Author(s):  
Noor Mohammad Noori ◽  
Alireza Teimouri

Background Ventricular septal defect, the most common congenital heart defect, is characterized by an opening between the ventricles. This study aimed to evaluate the clinical course and associations between the characteristics of ventricular septal defect. Methods This cross-sectional study was conducted on 1498 children with ventricular septal defects, aged <19 years, who were referred to our center between 2003 and 2018. The diagnosis was suspected from a combination of clinical and laboratory findings, and confirmed by transthoracic echocardiography. Results Of the 1498 children, 54.9% were boys, 78.4% of defects were perimembranous, 30.4% of patients had pulmonary hypertension, 67.5% had regular follow-up, and 76 (5.1%) had complications including 28 (1.9%) with Eisenmenger syndrome; 10 died due to Eisenmenger syndrome during follow-up. The defects closed spontaneously in 38.9% and after surgery in 20.9%. Boys tended to have more perimembranous, inlet, and outlet forms (56.40%, 50.60%, 51.90%, respectively), whereas girls had more muscular types (51.80%). Most patients with pulmonary hypertension had perimembranous defects (83.10%). The majority of patients with pulmonary hypertension had large (63.40%) or moderate (36.60%) defects. Pulmonary hypertension had a significant association with defect size ( p < 0.001). After surgery, residual defects were found mostly in cases of large defects (84.60%). Most patients with spontaneous closure were younger than 4 years. Conclusion Almost four-fifths of children with ventricular septal defects had perimembranous types, and almost one-third had pulmonary hypertension which was associated with defect size. Two-fifths of the defects closed spontaneously. There was a low incidence of complications after surgery.


1999 ◽  
Vol 138 (2) ◽  
pp. 339-344 ◽  
Author(s):  
Gurcharan S. Kalra ◽  
Puneet K. Verma ◽  
Anil Dhall ◽  
Sandeep Singh ◽  
Ramesh Arora

2017 ◽  
Vol 104 (3) ◽  
pp. 841-846 ◽  
Author(s):  
Xueying Song ◽  
Quansheng Xing ◽  
Qin Wu ◽  
Yueyi Ren ◽  
Hao Wan ◽  
...  

2020 ◽  
Author(s):  
Long Wang ◽  
Lin Xie ◽  
Weiqiang Ruan ◽  
Tao Li ◽  
Changping Gan ◽  
...  

Abstract Background: This report presents updated data and mid-term follow-up information to a former study introducing the novel technique of percutaneous-perventricular device closure of doubly committed subarterial ventricular septal defect. Methods: Thirty-eight patients were added to the former series. There were 54 patients in total who had isolated doubly committed subarterial ventricular septal defects and underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5-year follow-up. Results: Surgery was successful in 53 patients (98.1%). There was no death, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient developed pericardial effusion and tamponade in the former series. The mean hospital stay was 3.2±0.6 days (range, 3.0 to 6.0 days), and only one unsuccessful case needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be safe. Close monitoring for bleeding is essential postoperatively, especially in younger patients. This technique is generally safe with acceptable mid-term follow-up.


Author(s):  
Jin Yu ◽  
Jing Ye ◽  
Zewei Zhang ◽  
Xiuzhen Yang ◽  
Lianglong Ma ◽  
...  

Object: Investigate the value of transesophageal echocardiography (TEE) in perimembranous ventricular septal defect (PmVSD) closure via a left parasternal ultra‐minimal trans intercostal incision in children. Methods: From January 2015 and December 2020, 212 children with PmVSD were performed device occlusion via an ultraminimal intercostal incision. TEE is used throughout the perioperative period, including TEE assessment, TEE-guided localization of the puncture site, TEE guidance. All patients were followed up using transthoracic echocardiography for over 6 months. Results: A total of 207 cases successfully occluded, the successful rate was 97. 64%. one hundred and forty-five patients had single orifice, and 62 patients had multiple orifices in the AMS. During the operation, the surgeon readjusted the device or replaced the larger device in 17 cases. After operation, there were 19 cases of slight residual shunts, 13 cases of pericardial effusion and 4 cases of pleural effusion. And all were back to normal during the 4- month follow-up period. Mild mitral regurgitation was presented in 1 patient and remained the same during the follow-up period. No other complications were found. Conclusions: TEE was used to evaluate and determine the defect in PmVSDs with an concentric occluder via a left parasternal ultra‐minimal trans intercostal incision. TEE guidance and immediate postoperative efficacy evaluation are of great value, which can effectively guide the treatment of PmVSD occlusion.


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