Transcatheter closure of a residual shunt after surgical repair of traumatic ventricular septal defect

Abstract Background Transcatheter closure of intracardiac defects might be complicated by intravascular hemolysis. We evaluated hemolysis and its outcome after transcatheter closure of these defects. Methods and patients All patients who underwent transcatheter closure of patent ductus arteriosus, ventricular septal defect and atrial septal defect were included in this prospective study. Clinical data were obtained before and after the catheterization. Results One hundred and thirty-eight patients were enrolled; and four (3%) patients developed intravascular hemolysis; while two cases had residual shunt and two other cases had not residual flow. Although residual shunt occurred in ten patients, only 2 of these cases developed hemolysis. Patent ductus arteriosus closure was done for one of these cases and the other one, underwent perimembranous ventricular septal defect closure. Moreover, hemolysis occurred after device closure of patent ductus arteriosus in 2 of the other patients with no residual shunt. In this study the hemolysis was eliminated by conservative management within 2 weeks although residual shunt continued in this time. We observed a decline in lactate dehydrogenase value after catheterization in comparison with precatheterization, which was mainly among ventricular septal defect patients that might be due to mild chronic hemolysis in these patients. Conclusion Incidence of hemolysis after device closure was low, and occurred with and without residual flow and was eliminated by conservative management in 2 weeks, without the need for surgery, although the residual shunt was continued.

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Late surgical repair of a traumatic ventricular septal defect

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-014-0145-1 ◽

2014 ◽

Vol 9 (1) ◽

Cited By ~ 5

Author(s):

Leanne Harling ◽

Hutan Ashrafian ◽

Roberto P Casula ◽

Thanos Athanasiou

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Surgical Repair ◽

Traumatic Ventricular Septal Defect

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Transcatheter Closure of Perimembranous Ventricular Septal Defect with Aneurysm: Radiologic Characteristic and Interventional Strategy

Journal of Interventional Cardiology ◽

10.1155/2020/6646482 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Weibing Guo ◽

Yifan Li ◽

Jinjin Yu ◽

Junjie Li ◽

Ling Sun ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Transcatheter Closure ◽

Type A ◽

Left Ventricular ◽

Type B ◽

Residual Shunt ◽

Perimembranous Ventricular Septal Defect ◽

Type C

Objectives. We aimed to explore the radiologic characteristics and interventional strategies for perimembranous ventricular septal defect (pmVSD) with aneurysm. Methods. 257 patients who underwent transcatheter closure of pmVSD with aneurysm were included in our study. We retrospectively reviewed the left ventricular opening of the aneurysm (a), diameter of the midsegment of the aneurysm (b), and diameter of the right ventricular opening of the aneurysm (c). If there were multiple defects within the aneurysm, the largest defect was denoted as c1 and so forth. We developed a novel VSD classification method in which pmVSD with aneurysm was classified into three types (A, B, and C). When a >b ≥ c, it was classified as type A, when b > a ≥ c, it was type B, and when c > a ≥ b, it was type C; c/c1 described the relationship among defects. Results. All of the 257 cases of pmVSD with aneurysm were defined using left ventriculography: type A, 60, type B, 58, and type C, 139. Transcatheter closure was attempted in 244 patients and succeeded in 227 cases (success rate was 93.0%; 227/244). Forty symmetric VSD occluders and 13 asymmetric VSD occluders were used for type A aneurysm occlusion; 31 symmetric VSD occluders, 19 asymmetric VSD occluders, and one Amplatzer duct occluder II (ADOII) were used for type B; 59 VSD symmetric occluders, 59 asymmetric VSD occluders, three eccentric VSD occluders, and two ADOII were used for type C. Within 24 hours after procedure, 2.2% patients had postprocedural residual shunt, and 2.2% experienced malignant arrhythmia (including type II second-degree AVB, cAVB, and CLBBB). Two hundred and twelve patients completed follow-up (93%, 212/227). No new severe complications were reported during follow-up, except in one patient who underwent surgery (removal of the device, VSD repair, and tricuspid valvuloplasty) due to severe postprocedural tricuspid regurgitation. Conclusions. It is safe and effective to apply this method for the classification of pmVSD with aneurysm and its interventional strategy.

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A case of 10 year follow-up after transcatheter closure of a traumatic ventricular septal defect

European Heart Journal Supplements ◽

10.1093/eurheartj/suw032 ◽

2016 ◽

Vol 18 (suppl F) ◽

pp. F27-F30

Author(s):

Di Chi ◽

Yong Sun ◽

Miaoxin Tan ◽

Yang Zheng ◽

Xianglan Liu ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Transcatheter Closure ◽

Traumatic Ventricular Septal Defect

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Importance of transcatheter closure test for giant ventricular septal defect associated with pulmonary hypertension: a case with successful surgical repair of the defect

Cardiology in the Young ◽

10.1017/s104795111800046x ◽

2018 ◽

Vol 28 (8) ◽

pp. 1053-1055

Author(s):

Xiaoke Shang ◽

Rong Lu ◽

Nianguo Dong

Keyword(s):

Pulmonary Hypertension ◽

Ventricular Septal Defect ◽

Alternative Assessment ◽

Clinical Evidence ◽

Septal Defect ◽

Surgical Repair ◽

Transcatheter Closure ◽

Definitive Treatment ◽

Perimembranous Ventricular Septal Defect ◽

Cardiac Surgeons

AbstractThis is the first attempt to use a temporary occluder to close a giant perimembranous ventricular septal defect (32 mm), which obtains clinical evidence of good haemodynamics in patients with severe pulmonary hypertension. This may provide an alternative assessment to guide cardiac surgeons in determining a definitive treatment.

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Surgical Repair of Residual Shunt after Transcatheter Closure of Secundum Atrial Septal Defect with an Amplatzer Septal Occluder: a Case Report

Acta Chirurgica Belgica ◽

10.1080/00015458.2006.11679841 ◽

2006 ◽

Vol 106 (1) ◽

pp. 86-88

Author(s):

B. El Oumeiri ◽

J. L. Jansens

Keyword(s):

Case Report ◽

Atrial Septal Defect ◽

Septal Defect ◽

Surgical Repair ◽

Transcatheter Closure ◽

Amplatzer Septal Occluder ◽

Secundum Atrial Septal Defect ◽

Residual Shunt

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Primary Surgical Repair of Ventricular Septal Defect

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230301100307 ◽

2003 ◽

Vol 11 (3) ◽

pp. 213-216 ◽

Cited By ~ 9

Author(s):

M Kemal Demirag ◽

Hasan Tahsin Keçeligil ◽

Fersat Kolbakir

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Surgical Repair ◽

Primary Repair ◽

Ventricular Septal Defects ◽

Atrioventricular Canal ◽

Residual Shunt ◽

Mortality And Morbidity ◽

Septal Defects ◽

Early Primary

Between January 1983 and December 2000, 78 patients underwent primary repair of a ventricular septal defect. There were 42 males (54%) and 36 females (46%) of whom 13 (17%) were under 1 year old, 50 (64%) were aged 1–10 years, 11 (14%) were aged 10–20 years, and 4 (5%) were over 20 years old. The ventricular septal defect was a perimembranous type in 60 patients (77%), subarterial (outlet) type in 10 (13%), and atrioventricular canal (inlet) type in 4 (5%). Operative repair was performed with a patch in all except 2 patients. Early postoperative complications included insignificant aortic regurgitation in 4 patients, persistent complete heart block in 1, and residual shunt in 4. There were 5 early deaths (6.4%) and 1 late death (1.8%) in 56 patients followed up. Early primary closure of ventricular septal defects, usually via a right atriotomy, can be performed with acceptable mortality and morbidity rates.

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