scholarly journals The Short and Midterm Follow-Up of Transthoracic Device Closure of Perimembranous Ventricular Septal Defect in Adults

2018 ◽  
Vol 21 (4) ◽  
pp. E242-E246 ◽  
Author(s):  
Ze-wei Lin ◽  
Qiang Chen ◽  
Hua Cao ◽  
Gui-can Zhang ◽  
Liang-wan Chen ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Cardiac Function ◽  
Septal Defect ◽  
Clinical Status ◽  
Perioperative Period ◽  
Device Closure ◽  
Total Occlusion ◽  
Perimembranous Ventricular Septal Defect ◽  
Malignant Arrhythmia

Background: The purpose of this study was to assess the short- and mid-term follow-up results of transthoracic device closure of perimembranous ventricular septal defect (pmVSD) in adults.Methods: Sixty-one adults underwent transthoracic device closure of pmVSD at our institution from Jan. 2012 to Jan. 2016. All relevant clinical data were recorded and analyzed. All patients were invited to undergo contrast transthoracic echocardiography (TTE) for 12 months to 60 months after VSD closure. Phone interviews were conducted to further evaluate the cardiac function status.Results: All patients were successfully occluded using this procedure. The most frequent complication was transient cardiac arrhythmia, which was easily treated during the perioperative period. During the follow-up period, we found no recurrence, malignant arrhythmia, thrombosis, device embolization, valve damage, device failure, or cases of death. The total occlusion rate was 100 percent in the 12 months of follow-up, and most of patients showed significant improvement in their clinical status. From the TTE data, the intracardiac structure and cardiac function were improved in the follow-up.Conclusion: Transthoracic device closure of perimembranous ventricular septal defect in adults is a safe and feasible technique. The short- and mid-term follow-up results were satisfactory, but long-term follow-up is required to better assess the safety and feasibility of this method in adults.

scholarly journals Value of transesophageal echocardiography in device closure of perimembranous ventricular septal defects in children via an ultraminimal intercostal incision

2021 ◽  
Author(s):  
Jin Yu ◽  
Jing Ye ◽  
Zewei Zhang ◽  
Xiuzhen Yang ◽  
Lianglong Ma ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Septal Defect ◽  
Perioperative Period ◽  
Ventricular Septal Defects ◽  
Device Closure ◽  
Efficacy Evaluation ◽  
Puncture Site ◽  
Septal Defects ◽  
Perimembranous Ventricular Septal Defect

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.

scholarly journals Midterm Results of Transaxillary Occluder Device Closure of Perimembranous Ventricular Septal Defect Guided Solely by Transesophageal Echocardiography

2019 ◽  
Vol 22 (2) ◽  
pp. E112-E118
Author(s):  
Weijie Liang ◽  
Sijie Zhou ◽  
Taibin Fan ◽  
Shub Song ◽  
Bin Li ◽  
...  
Keyword(s):  
Adverse Events ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Device Closure ◽  
Bundle Branch Block ◽  
Surgical Closure ◽  
Perimembranous Ventricular Septal Defect ◽  
Occluder Device ◽  
The Mean

Background: Perimembranous ventricular septal defect (pmVSD) is a common congenital heart disease. Transaxillary occluder device closure of the pmVSD has been proved effective and an alternative to surgical closure. The study aimed to evaluate the immediate operation outcomes and the early and midterm follow-up outcomes of transaxillary occluder device closure. Methods: From January 2014 to December 2017, we retrospectively analyzed the patients who underwent transaxillary device closure of the pmVSD. All patients underwent transthoracic echocardiography (TTE), chest x-ray, and electrocardiogram (ECG) before and after the procedure (before discharging). Follow-up evaluation was completed at the time of 3, 6, 12 months and yearly thereafter in outpatient setting with TTE and ECG. Results: A total of 428 patients (216 male, 212 female) underwent transaxillary occluder device closure of the pmVSD under the guidance of transesophageal echocardiography (TEE). The mean age at the operation time was 2.2 ± 1.5 year (range 0.5-16.2 year). The mean weight was 8.5 ± 4.1 kg (range 6-61 kg). The mean size of the occluder implanted in the operation was 5.3 ± 1.4 (range 4-8 mm), matching the mean defect size of 4.2 ± 1.1 (range 3-6 mm). The device closure operation was successfully achieved in 422 pmVSD patients (98.6%), and 6 patients failed in occluding and were converted to open surgery because of a great residual shunt and obvious device-related aortic regurgitation . Immediate complete closure was detected by postoperative TEE in all, but 3 patients had trivial residual shunting. Total early adverse events emerged in 47 patients (11.1%). New mild tricuspid and aortic regurgitation occurred in 17 and 3 patients and disappeared in follow-up. Abnormal atrioventricular conduction events emerged in 23 patients, including left anterior block, complete right bundle branch block (CRBBB), incomplete right bundle branch block (IRBBB), administrated with close follow-up. Pericardial effusion occurred in 2 other patients, managed with puncture drainage. During a median follow-up period of 26.8 months (range 6-48 months), no serious adverse event and later-on complete atrioventricular block were encountered. Conclusion: In our experience, transaxillary device closure was performed via right infra-axillary mini-incision (invisible) guided by TEE, with low incidence of postoperative adverse events, confirming that transaxillary device closure of the pmVSD under the guidance of TEE is an effective alternative to surgical closure in well-selected pmVSD patients.

scholarly journals Device Closure of Perimembranous Ventricular Septal Defect Under Deep Sedation and Transthoracic Echo Guide: A Case Report

1970 ◽  
Vol 3 (1) ◽  
pp. 89-91
Author(s):  
NN Fatema ◽  
H Rashid ◽  
AK Azad
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Deep Sedation ◽  
Military Hospital ◽  
Device Closure ◽  
Colour Doppler ◽  
Catheterization Laboratory ◽  
Perimembranous Ventricular Septal Defect ◽  
Amplatzer Device

T, an eight years old girl was diagnosed as a case of perimembranous Ventricular Septal Defect (VSD) since 6 months of her age. She had recurrent chest infection since early infancy. Her Echocardiography with colour Doppler showed a 4.5 mm perimembranous VSD which was 5 mm away from the aortic valve. As pulmonary artery pressure was normal, she was kept under follow up and device closure was planned. At last she was taken into the catheterization laboratory of combined military Hospital, Dhaka on 1st July 2008 and VSD was closed with an 8 mm Amplatzer perimembranous VSD device. Whole procedure was done under deep sedation with Ketamine and transthoracic echocardiography (TTE) and fluroscopy guide. It is the first ever case of VSD device closure where procedure was done under sedation and TTE guide which lead to the writing of this report.Keywords: VSD; Transthoracic Echo; Amplatzer Device. DOI: 10.3329/cardio.v3i1.6432Cardiovasc. j. 2010; 3(1): 89-91

Transcatheter device closure of perimembranous ventricular septal defect in children treated with prophylactic oral steroids: acute and mid-term results of a single-centre, prospective, observational study

2015 ◽  
Vol 26 (4) ◽  
pp. 669-676 ◽  
Author(s):  
Bhavesh Thakkar ◽  
Nehal Patel ◽  
Shomu Bohora ◽  
Dharmin Bhalodiya ◽  
Tarandeep Singh ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Heart Block ◽  
Septal Defect ◽  
Device Closure ◽  
Conduction Disturbances ◽  
Perimembranous Ventricular Septal Defect ◽  
Post Procedure ◽  
Oral Steroids ◽  
Transcatheter Device

AbstractBackground and ObjectiveAlthough transcatheter closure of perimembranous ventricular septal defect is emerging as an accepted, viable alternative, conduction disturbances still remain a major concern. Although steroid treatment has shown encouraging results with complete recovery, efficacy of prophylactic use of steroids is still speculative. We aim to study the mid-term outcome of perimembranous ventricular septal defect closure in children who received prophylactic oral steroids.Materials and methodsA prospective study was designed and antegrade device closure was attempted in eligible children who met the following inclusion criteria: age 3–18 years and weight >10 kg, defect diameter ⩽12 mm, and symptomatic, haemodynamic changes or history of infective endocarditis. Prophylactic steroid protocol consisted of 2 weeks oral prednisolone (1 mg/kg/day) initiated immediately after the procedure, and in the event of bradyarrhythmia it was escalated to 2 mg/kg. Patients were regularly followed-up at 1, 6, and 12 months and then annually. Patients with post-procedure heart block underwent Holter monitoring after a minimum of 1 year interval.ResultsBetween May, 2007 and August, 2012, successful device closure was accomplished in 290/297 patients. Mean age and weight were 9±3.12 years and 21±8.27 kg, respectively. The defect measured 5±1.38 mm on echocardiography. Mean fluoroscopy time was 12.98±8.64 minutes. Eight patients with major complications included one each with device embolisation, haemolysis, severe aortic regurgitation, and five with bradyarrhythmias, including complete atrioventricular block in three, Mobitz II in one, and bifascicular block in one. Patients with complete atrioventricular block responded to high-dose steroid and temporary pacemaker. Minor complications included post-procedure heart block (n=22) and blood loss (n=2). At 18.23±13.15 months follow-up, 8/27 (five major, 22 minor) with arrhythmia had persistent post-procedure heart block of no clinical consequences.ConclusionIn our patient population, transcatheter device closure of the perimembranous ventricular septal defect with prophylactic oral steroid resulted in excellent closure rate and acceptably low incidence of conduction disturbances at mid-term follow-up.

Complete atrio-ventricular heart block, a not to be forgotten complication in transcatheter closure of perimembranous ventricular septal defect – a case report and review of literature

2021 ◽  
pp. 1-4
Author(s):  
Ming Chern Leong ◽  
Mazeni Alwi
Keyword(s):  
Ventricular Septal Defect ◽  
Heart Block ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Review Of Literature ◽  
Device Closure ◽  
Bundle Branch Block ◽  
Know How ◽  
Perimembranous Ventricular Septal Defect ◽  
New Onset

Abstract Device occlusion of perimembranous ventricular septal defect is gaining popularity with the emergence of newer, softer occluders and improved technical know-how. We report a 26-year-old lady with a moderate size perimembranous ventricular septal defect who had a new onset of bundle branch block shortly after device closure. The patient subsequently developed a complete atrio-ventricular heart block.

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.

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