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.

scholarly journals Transcatheter closure of muscular ventricular septal defects using the Cardi-O-Fix plug

2021 ◽  
pp. 1-4
Author(s):  
Zhisong Chen ◽  
Zhuo Yu ◽  
Li Su ◽  
Huasheng Zhang ◽  
Wei Hu
Keyword(s):  
Transcatheter Closure ◽  
Left Ventricular ◽  
Defect Size ◽  
Ventricular Septal Defects ◽  
Chordae Tendineae ◽  
Effective Treatment Option ◽  
Septal Defects ◽  
Device Implantation ◽  
The Right

Abstract Objective: The aim of this study was to evaluate the safety and efficacy of the Cardi-O-Fix plug used for the treatment of muscular ventricular septal defects. Methods: We retrospectively reviewed the medical records of five patients with muscular ventricular septal defects who underwent transcatheter closure using the Cardi-O-Fix Plug, from November 2017 to August 2019. The median age was 5.1 years (range: 3.2–6.5). Their median body weight was 18.1 kg (range: 13.4–21.8). All the patients underwent detailed two-dimensional Doppler and colour flow imaging by transthoracic echocardiography. The left ventricular median defect size of the muscular ventricular septal defects was 5.6 mm (range: 5.3–7.0). The right ventricular median defect size of the muscular ventricular septal defects was 3.9 mm (range: 3.3–4.7). All the procedures were performed on beating hearts. Results: All the patients underwent successful device implantation with no displacement or detachment, they have complete echocardiographic closure at the 1-year follow-up. There were no occluder-related arrhythmia, chordae tendineae rupture, tricuspid insufficiency, aortic regurgitation, haemolysis, or embolisation. Conclusions: Application of the Cardi-O-Fix plug appears to be a feasible, safe, and effective treatment option for patients with muscular ventricular septal defects. Longer follow-up periods are warranted to prove the conclusion for long-term outcomes.

scholarly journals Short- and medium-term follow-up of transcatheter closure of perimembranous ventricular septal defects

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hao Li ◽  
Youyang Shi ◽  
Songyue Zhang ◽  
Yue Ren ◽  
Xing Rong ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Interventional Cardiology ◽  
Ventricular Septal Defects ◽  
Tricuspid Valve Regurgitation ◽  
Serious Adverse Event ◽  
Septal Defects ◽  
Device Implantation ◽  
Mean Size ◽  
The Mean

Abstract Background Transcatheter closure of perimembranous ventricular septal defects is one of the greatest challenges in interventional cardiology. Short- and midium-term follow-up data for large samples are limited. This report presents our experience with transcatheter closure of perimembranous ventricular septal defects using an occluder. Methods Two hundred fifty-three patients included in the database of the Second Affiliated Hospital and Yuying Children’s Hospital from January 2011– December 2015 with transcatheter closure of perimembranous ventricular septal defects and discharged from follow-up. All patients were invited for clinical and transthoracic echocardiography, electrocardiogram, and thoracic radiography check-up. Results Device implantation was successful in 252 of 253 patients (99.6%). The median age was 42 months (range 27–216 months). The median follow-up duration was 36 months (range 6–60 months). The mean defect diameter was 3.5 ± 1.4 mm and the mean size of the ventricular septal defect rim below the aortic valve was 3.7 ± 1.8 mm. The mean diameter of the devices used was 4 mm. Thirty-seven patients developed arrhythmia after the procedure and recovered within 24 months; four patients had hemolysis and four had moderate tricuspid valve regurgitation. No other serious adverse event occurred during the follow-up period. Conclusion Transcatheter closure of perimembranous ventricular septal defects using an occluder is safe and effective in most patients.

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 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.

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.

scholarly journals Individualized Experience With Percutaneous Transcatheter Closure of Multiple Atrial Septal Defects: A Single-Center Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhenquan Wang ◽  
Yi Zhan ◽  
Jiahui Jin ◽  
Tingting Wu ◽  
Songyue Zhang ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Atrial Septal Aneurysm ◽  
Single Center ◽  
Residual Shunt ◽  
Closure Rate ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Single Center Study ◽  
Center Study

Multiple atrial septal defects (ASDs) are one type of secundum ASD, most of which have an atrial septal aneurysm or long interdefect distance. In our retrospective single-center study, we reviewed different closure strategies for multiple ASDs. We analyzed 50 patients who underwent percutaneous transcatheter closure from May 2011 to July 2019. Information on the patients' characteristics, operation procedure, occluder selection, and complications was collected. According to the feature of the defects and device choice, multiple ASDs were divided into five groups. A successful operation was achieved in every patient. A total of 50 patients were implanted with 58 devices, with 26 patients implanted with a single standard ASD occluder (ASDO); six patients were implanted with double standard ASDOs, and only one patient was implanted with three standard ASDOs. There were 17 patients whose closure was made using the small-waist–big-edge ASDO. Seventy-six percent of the patients (38/50) had an immediate residual shunt. During the mean follow-up of 25.76 ± 22.53 months, the complete closure rate was 92%. Except for two patients with a transient atrioventricular block, individualized experience with percutaneous transcatheter closure for multiple ASDs was effective in a single-center study. After a mid- to long-term follow-up, the multiple ASDOs and small-waist–big-edge ASDO had no serious adverse events or complications.

scholarly journals Endovascular treatment of postinfarction ventricular septal defects

2016 ◽  
Vol 20 (2) ◽  
pp. 80
Author(s):  
D. A. Khelimskiy ◽  
O. V. Krestyaninov ◽  
A. G. Osiev ◽  
A. A. Shermuk ◽  
D. S. Grankin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Transcatheter Closure ◽  
Clinical Status ◽  
Multiple Organ ◽  
Defect Size ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Device Implantation ◽  
Implanted Devices

<p><strong>Aim:</strong> The study was designed to evaluate the possibility and safety of transcatheter closure of postinfarction ventricular septal defects in different periods after acute myocardial infarction.<br /><strong>Methods:</strong> Over a period from 2010 to 2015 15 patients (11 females and 4 males) underwent transcatheter closure of postinfarction ventricular septal defects. The time from the onset of infarction to the intervention varied between 1 day and 6 months (mean 10.9 weeks). Three patients were treated in an acute phase of infarction (two weeks or less). The defect size ranged 7-24 mm (mean 13.5 mm), while the implanted devices sized 12-34 mm (mean 22.8 mm). The procedure and screening time amounted to 67-170 (mean 115.3) and 14-78 (mean 32.5) minutes respectively.<br /><strong>Results:</strong> A successful device implantation occurred in all but one patient whose occluder was dislodged. This patient later underwent successful surgical VSD closure. Occluder implantation failed to improve the clinical status of two patients in a critical condition. They developed multiple organ failure and died at 2 and 9 days after the procedure.<br /><strong>Conclusion:</strong> Transcatheter closure of postinfarction ventricular septal defects may be an alternative to surgery in patients with suitable anatomy and multiple comorbidities. However, in-hospital mortality remains high, even after successful occluder implantation.</p>

scholarly journals Transcatheter closure of perimembranous and muscular ventricular septal defects: short and medium-term outcome

2020 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Success Rate ◽  
Transcatheter Closure ◽  
Central Hospital ◽  
Ventricular Septal Defects ◽  
Medium Term ◽  
Term Outcome ◽  
Surgical Closure ◽  
Septal Defects ◽  
First Choice

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

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