scholarly journals Transcatheter Closure of Perimembranous and Intracristal Ventricular Septal Defects Using Amplatzer Duct Occluder II in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Shenrong Liu ◽  
Wenqian Zhang ◽  
Junjie Li ◽  
Shushui Wang ◽  
Mingyang Qian ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Amplatzer Duct Occluder ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Total Range ◽  
New Onset

Background. Transcatheter closure of aneurysmal perimembranous ventricular septal defect (pmVSD), pmVSD near the aortic valve, and intracristal VSD (icVSD) with symmetrical or asymmetrical ventricular septal defect occluders still presents significant challenges. We report our experience with transcatheter closure of pmVSD and icVSD using Amplatzer duct occluder II (ADO II) in children. Method. We retrospectively analyzed all children, who presented to our hospital consecutively between March 2014 and June 2020 for attempted transcatheter closure of pmVSD or icVSD with the ADO II device. Standard safety and last-follow-up outcomes were assessed and compared. Results. In total, 41 patients underwent transcatheter closure of VSD with the ADO II (28 in pmVSD and 13 in icVSD groups) with a median age of 3.5 years (total range: 0.9 to 12 years) and median weight of 15.0 kg (total range: 10.0 to 43.0 kg). Implantation was successful in 40/41 patients (97.5%, 27/28 in pmVSD group, 13/13 in icVSD group). One patient with mild aortic valve prolapse in pmVSD group developed new-onset moderate aortic regurgitation after a 4/4 mm ADO II was deployed; however, this resolved after the device was retrieved and successfully replaced with a 5 mm zero eccentric VSD occluder. There was no procedure-related mortality. After a median follow-up of six months (total range: 6 to 72 months), complete closure rates were 85.1% and 76.9% among pmVSD and icVSD groups, respectively. In the pmVSD group, one case of new-onset moderate tricuspid regurgitation was observed at six months, and there was one case of severe tricuspid regurgitation that had progressed from mild tricuspid regurgitation at 12 months. No serious complications were noted in the icVSD group. Conclusion. ADO II provides a safe and reproducible alternative for the closure of perimembranous and intracristal ventricular septal defects with a diameter less than 5 mm in young children.

scholarly journals Transcatheter Closure of Atrial Septal Defects with 40 mm Septal Occluder in Shahid Gangalal National Heart Centre, Nepal

2021 ◽  
Vol 18 (2) ◽  
pp. 49-51
Author(s):  
Chandra Mani Adhikari ◽  
Kiran Prasad Acharya ◽  
Amrit Bogati ◽  
Anjana Acharya ◽  
Roshani Shahi ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Tricuspid Regurgitation ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Device Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
National Heart ◽  
Single Center Study

Background and Aims:  Transcatheter closure of Atrial septal defect (ASD) is one of important modality of treatment these days for ASD secundum. However, there is a paucity of data on transcatheter closure of ASDs with ³40 septal occluder. We aim to study the outcome of ASD device closure with  ³40 mm Septal Occluder in Shahid Gangalal National Heart Centre, Nepal. Methods:   It was a prospective single center study conducted at Shahid Gangalal National Heart Centre, Nepal.Among the 27 patient who underwent successful device closure with ³40 mm devices from January 2016 till December 2019, twenty-six patients could be prospectively followed up during May 2020 till December 2020. A Performa was designed to collect information about age, gender, ASD size, ASD device type and size. Right atrium(RA) and right ventricle(RV) dimension, level of tricuspid regurgitation (TR) and tricuspid regurgitation pressure gradient before the procedure and at the time of follow up were also recorded. Results: Amplatzer septal occluder (40mm) was used in 25 (96.1%) patients and Memopart device (42mm) was used in 1 (3.9%) patient.  Before the procedure all patients had dilated RA and RV, Mild TR, moderate TR and severe TR was present in 14 (53.8%), 10 (38.4%) and 2 (7.7%) patients respectively. At follow up, only one (3.9%) patient had dilated RA and RV. Mean Tricuspid regurgitation pressure gradient decreased from mean 44.4 mmHg to 18.9 mmHg. Conclusion: Transcatheter Closure of Atrial Septal Defects with ³40 mm Septal Occluder is safe and effective in short term follow up.

Transcatheter closure of a membranous ventricular septal defect in a 1.8-kg infant using Amplatzer Duct Occluder II additional size device

2017 ◽  
Vol 27 (7) ◽  
pp. 1437-1440
Author(s):  
Bhavik Champaneri ◽  
Mahesh Kappanayil ◽  
Raman K. Kumar
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Artery Occlusion ◽  
Amplatzer Duct Occluder ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Femoral Artery Occlusion ◽  
Catheter Closure ◽  
The Right

AbstractCatheter closure of membranous ventricular septal defects is generally not considered feasible in small infants. We report the successful closure of a membranous ventricular septal defect in a 1.8-kg infant with bilateral femoral artery occlusion using Amplatzer Duct Occluder II additional size device. The ventricular septal defect was crossed from the right ventricle, and the device was deployed using transthoracic echocardiographic guidance.

Transcatheter closure of perimembranous ventricular septal defects with ductal occluders

2014 ◽  
Vol 25 (5) ◽  
pp. 918-926 ◽  
Author(s):  
Jayaranganath Mahimarangaiah ◽  
Anand Subramanian ◽  
Srinivasa Kikkeri Hemannasetty ◽  
Subhash Chandra ◽  
Satish Karur ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Tricuspid Regurgitation ◽  
Heart Block ◽  
Complete Heart Block ◽  
Ductus Arteriosus ◽  
Amplatzer Duct Occluder ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Patent Ductus ◽  
New Onset

AbstractBackground: To study the feasibility and complications associated with the use of ductal occluders for closure of perimembranous ventricular septal defects. Methods: A total of 126 patients, ranging from 1 to 41 years of age (median – 8 years), underwent closure of ventricular septal defects from August 2010 to April 2013. Small- and moderate-sized defects were closed using first-generation Patent ductus arteriosus occluders or Amplatzer Duct Occluder-II. Patients were followed up for the development of complications such as heart block, aortic regurgitation, and tricuspid regurgitation. Results: Patent ductus arteriosus occluders were used in 81 patients, and the Amplatzer Duct Occluder-II device in 45 patients. The devices were successfully deployed in 99.2% of the cases. One patient had embolisation of an Amplatzer Duct Occluder-II device soon after deployment. There was one case of transient complete heart block (0.8%) needing temporary pacing, and two cases of isoarrhythmic atrioventricular dissociation (1.6%). One patient developed late-onset complete heart block 15 months after the procedure and underwent permanent pacemaker implantation. There were no instances of new-onset aortic regurgitation. New-onset mild tricuspid regurgitation was seen in two patients. Of the patients, three had small residual shunts on follow-up, without haemolysis. Conclusions: Duct occluders can be used to effectively close small- and moderate-sized ventricular septal defects. The incidence of complete heart block and valvular regurgitations are much less than reported with other devices, and they are cost-effective.

Transcatheter closure of doubly committed subarterial ventricular septal defects with the Amplatzer ductal occluder: initial experience

2019 ◽  
Vol 29 (5) ◽  
pp. 570-575
Author(s):  
Yu Huang ◽  
Xiaoping Yan ◽  
Linxiang Lu ◽  
Jun Fang ◽  
Xudong Sun ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Aortic Regurgitation ◽  
Transcatheter Closure ◽  
Ventricular Septal Defects ◽  
Residual Shunt ◽  
Septal Defects ◽  
Device Implantation ◽  
Limited Experience ◽  
New Onset

AbstractBackground:There is limited experience about transcatheter closure of doubly committed subarterial ventricular septal defects with Amplatzer ductal occluder.Methods:Between March, 2015 and July, 2017, a total of 22 patients with doubly committed subarterial ventricular septal defects received transcatheter closure using Amplatzer ductal occluder and underwent clinical follow-up for at least 6 months.Results:Device implantation was finally successful in 21 (95.4%) patients despite failed occlusion in one patient and intra-procedural replacement of unsuitable occluders in four (19.0%) patients. In mean 12.3 months of follow-up, there were no major complications (death, aortic valve or sinus rupture, device dislocation or embolisation, grade 2 new-onset aortic regurgitation, etc.), resulting in clinical occlusion success of 95.4%. Mechanical haemolysis occurred in one patient and resolved with medication. Residual shunt was observed in 11 (52.4%) patients (9 mild, 2 moderate-severe) post-procedurally, 14 (66.7%) patients (12 mild, 2 moderate-severe) in hospital stay, and 2 (9.5%) patients (2 mild, 0 moderate-severe) at the last follow-up. Device-induced new-onset aortic regurgitation was found in nine (42.8%) patients (9 mild, 0 moderate-severe) post-procedurally and in hospital stay, which was resolved in two (9.5%) patients and unchanged in seven (33.3%) patients at the last follow-up. Another four (19.0%) patients newly developed mild aortic regurgitation during follow-up.Conclusions:Transcatheter closure of doubly committed subarterial ventricular septal defects with Amplatzer ductal occluder is technically feasible in the selected patients. However, further study is needed to confirm its long-term clinical outcomes.

Assessment of ventricular septal defect with aortic valvar prolapse by means of echocardiography and angiography

1994 ◽  
Vol 4 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Jou-Kou Wang ◽  
Hung-Chi Lue ◽  
Mei-Hwan Wu ◽  
Ming-Lon Young ◽  
Ing-Sh Chiu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Sinus Of Valsalva ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Mean Size ◽  
The Mean ◽  
The Right

SummaryA total of 80 patients, diagnosed by echocardiography as having ventricular septal defect with aortic valvar prolapse, underwent cardiac catheterization and surgery. Echocardiographic and angiographic results were compared with surgical findings. The ventricular septal defects as observed during surgery were found to be doubly committed and subarterial in 49 (61%), muscular outlet in 10 (13%), and perimembranous in 21(26%). The location had been erroneously categorized by echocardiography and angiography in 12 (15%) and in 15 (19%) patients, respectively. Prolapse of the right coronary leaflet of the aortic valve, as documented by echocardiography, was confirmed by angiography in all but two cases. Prolapse of the noncoronary leaflet was detected by both imaging modalities in three patients. Prolapse of the right coronary and noncoronary leaflets was observed at surgery in 49 and three patients, respectively. The mean size of the ventricular septal defect, when measured by echocardiography, was significantly smaller than that found following surgical measurements (3.3±1.3 vs 8.4±3.8 mm, p<0.001). Our study showed that the ventricular septal defect was erroneously classified in the presence of prolapse of the aortic valve in 15% and 19% of our cases by echocardiography and angiography, respectively. The herniated sinus of Valsalva forming the “roof” of the ventricular septal defect probably redirected the jet across the defect to cause the errors in interpretation. Echocardiography, nevertheless, is as reliable as angiography in our hands in the follow-up of patients with ventricular septal defect opening to the outlet of the right ventricle.

scholarly journals Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

2020 ◽  
Author(s):  
Long Wang ◽  
Lin Xie ◽  
Weiqiang Ruan ◽  
Tao Li ◽  
Changping Gan ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Close Monitoring ◽  
The Novel ◽  
Ventricular Septal Defects ◽  
Device Closure ◽  
Residual Shunt ◽  
Septal Defects ◽  
Perventricular Device Closure

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.

Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder

1999 ◽  
Vol 9 (5) ◽  
pp. 468-473 ◽  
Author(s):  
Felix Berger ◽  
Peter Ewert ◽  
Per G. Boöjrnstad ◽  
Ingo Dähnert ◽  
Gregor Krings ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Paradoxical Embolism ◽  
Residual Shunt ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Diagnostic Cardiac Catheterization ◽  
Long Term Follow Up

AbstractTo judge whether an Amplatzer™ Septal Occluder can be used as standard therapy instead of surgery for closure of atrial septal defects we report our experiences in 200 patients. Of these patients, 127 had an atrial septal defect with haemodynamically significant left-to-right shunt, 68 patients a persistent oval foramen after presumed paradoxical embolism, and 5 had a fenestration after Fontan-repair. Mean age was 29.8 years (0.8 to 77.7 years). Body weight ranged from 6.9 to 120.0 kg (mean 51.5 kg). After diagnostic cardiac catheterization, and balloon-sizing of the defect, we implanted Amplatzer™ Septal Occluders with stents of 4 to 28 mm diameter. Follow-up studies were obtained after 48hours, and one, six, and twelve months. Transcatheter closure of the atrial septal defect proved successful in all without any relevant residual shunts. In particular, complete closure was achieved in all patients after presumed paradoxical embolism. The mean period of follow-up is 9–5 months, with a range from 0.4 to 23.5 months, giving a total of 1898 patient months. The occlusion rate after three month was 98.1°. A trivial haemodynamically insignificant residual shunt remained in 1.9° of the patients. Fluoroscopy times ranged from 0 to 43.5 minutes, with a median of 8.7 minutes. The excellent results in the short and medium term in children and adults have resulted in using this device routinely at the present time for closure of central atrial septal defects up to a diameter of 28 mm. Final judgement, however, is only possible after long-term follow-up.

Clinical course in children and adolescents with ventricular septal defect

2019 ◽  
Vol 27 (7) ◽  
pp. 529-534
Author(s):  
Noor Mohammad Noori ◽  
Alireza Teimouri
Keyword(s):  
Pulmonary Hypertension ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Clinical Course ◽  
Defect Size ◽  
Eisenmenger Syndrome ◽  
Ventricular Septal Defects ◽  
Laboratory Findings ◽  
Septal Defects

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.

Sign in / Sign up

Export Citation Format

Share Document