Outcomes of closure of doubly committed subarterial ventricular septal defects in adults

2020 ◽  
Vol 30 (5) ◽  
pp. 599-606
Author(s):  
Zhaoyang Chen ◽  
Wanhua Chen ◽  
Hang Chen ◽  
Zhenmei Liao ◽  
Qiang Chen ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ventricular Septal Defect ◽  
Aortic Regurgitation ◽  
Septal Defect ◽  
Intervention Group ◽  
Adult Patients ◽  
Defect Closure ◽  
Ventricular Septal Defect Closure ◽  
Sinus Valsalva Aneurysm

AbstractBackground:Outcome data of doubly committed subarterial ventricular septal defect closure in adults are limited.Methods:A review was made of the inpatients >18 years of age who underwent doubly committed subarterial ventricular septal defect closure between June 2010 and June 2017.Results:The patients were categorised into two groups: The valve intervention group consisted of 31 patients who underwent aortic valvuloplasty, aortic valve replacement, or repair of sinus Valsalva aneurysm in addition to doubly committed subarterial ventricular septal defect closure; non-valvular intervention group comprised 58 patients who underwent only doubly committed subarterial ventricular septal defect closure. The groups did not differ by sex and age. Patients in the valve intervention group, with a larger ventricular septal defect size, were shorter and tended to be lighter. The valve intervention group had more patients with pneumonia perioperatively. No infective endocarditis and reoperation were noted during the study period. At last follow-up, 91 and 96.6% of the studied patients were free from left ventricle dilation and pulmonary hypertension. In patients without pre-operative aortic regurgitation, 12 developed new mild aortic regurgitation during the follow-up.Conclusions:About 34.8% of adult patients with doubly committed subarterial ventricular septal defect required concurrent intervention on aortic valve or sinus Valsalva aneurysm. The midterm results of doubly committed subarterial ventricular septal defect closure in adult patients were favourable. However, the incidence of new mild aortic regurgitation after ventricular septal defect closure was high (27.3%). Long-term follow-up of aortic regurgitation progression is needed.

Percutaneous closure of ventricular septal defect using LifeTechTM Konar-MF VSD Occluder: initial and short-term multi-institutional results

2021 ◽  
pp. 1-7
Author(s):  
Masood Sadiq ◽  
Ahmad Usaid Qureshi ◽  
Muhammad Younas ◽  
Sohail Arshad ◽  
Syed Najam Hyder
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Regurgitation ◽  
Septal Defect ◽  
Defect Closure ◽  
Short Term ◽  
Ventricular Septal Defect Closure ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

Abstract Background: Transcatheter ventricular septal defect closure remains a complex procedure with potential complications like complete heart block and aortic regurgitation. The ideal device design for such intervention is still evolving. Aim: To assess the safety, efficacy, and short-term outcome of ventricular septal defect closure using LifeTechTM multifunctional (KONAR-MFTM) VSD Occluder. Patients and methods: In a multicenre study, 44 patients with haemodynamically significant, restrictive ventricular septal defects underwent closure with the KONAR-MFTM device from April, 2019 to March, 2020. Clinical, echocardiographic, and angiographic data were collected and reviewed. Patients were followed up at 1, 3, 6, and 12 months. Results: The median age and weight were 8 (1.7–36) years and 20 (11–79) kg. Of 44 patients, 8 (18%) had a high muscular and 36 (82%) had a perimembranous defect, of which 6 had mild prolapse of the right coronary cusp. The median ventricular septal defect size was 8.8 (3.9–13.4) mm. A retrograde approach was adopted in 39 (88.6%) patients. Nine patients (20.5%) had a small residual leak and there was a slight increase in aortic regurgitation in one patient. One device, which embolised to pulmonary artery was retrieved, and the defect was closed with a larger device. At a median follow-up of 13 (5–18) months, the residual leak persisted in 1 (2.3%) patient. Mild aortic regurgitation in one patient remained unchanged. There were no major complications. Conclusion: Percutaneous closure of ventricular septal defect using KONAR-MFTM device is safe and effective in short and midterm follow-up including selected patients with perimembranous defect and mild prolapse of the right coronary cusp.

Intraoperative diagnosis of a quadricuspid aortic valve

2017 ◽  
Vol 26 (9) ◽  
pp. 704-706
Author(s):  
Hassan Tatari ◽  
Maziar Gholampour Dehaki ◽  
Gholamreza Omrani ◽  
Hafez Ghaheri ◽  
Alwaleed Al-Dairy ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Septal Defect ◽  
Incidental Finding ◽  
Aortic Valve Repair ◽  
Quadricuspid Aortic Valve ◽  
Valve Regurgitation ◽  
Valve Repair ◽  
Ventricular Septal Defect Closure

Quadricuspid aortic valve is a rare anomaly, and most patients require surgery for aortic regurgitation in the 5th or 6th decades of life; only a few cases of aortic valve repair in childhood have been reported. A 3-year-old boy was scheduled for ventricular septal defect closure and aortic valve repair. Quadricuspid aortic valve was an incidental finding at operation; it was repaired by joining the left anterior and right anterior cusps. At the 9-month follow-up, the patient had no more than mild aortic regurgitation. We emphasize the importance of detecting this anomaly, especially in children with aortic valve regurgitation.

scholarly journals Progression of Aortic Regurgitation After Subarterial Ventricular Septal Defect Repair: Optimal Timing of the Operation

2019 ◽  
Vol 40 (8) ◽  
pp. 1696-1702
Author(s):  
Hanna Jung ◽  
Joon Yong Cho ◽  
Youngok Lee
Keyword(s):  
Aortic Valve ◽  
Ventricular Septal Defect ◽  
Aortic Regurgitation ◽  
Septal Defect ◽  
Preoperative Evaluation ◽  
Optimal Operation ◽  
Optimal Timing ◽  
Mild Degree ◽  
Operation Timing

Abstract In patients with subarterial ventricular septal defect (VSD), the progression of aortic regurgitation (AR) still remains unclear. This review is to identify the incidence of AR progression after VSD repair and to determine the optimal operation timing for subarterial VSD repair with or without aortic valve prolapse or AR. From January 2002 to December 2015, 103 patients who underwent subarterial VSD repair alone at our hospital were reviewed. All patients routinely underwent echocardiography (echo) performed by our pediatric cardiologists. The operative approach was through the pulmonary artery in all patients. The median age of patients at operation was 10 months (range 3 to 16.5 months). Eighty-nine patients (86.4%) underwent subarterial VSD closure before the age of 4 years. In the preoperative evaluation, 27.2% (28 patients) of the patients showed more than faint degree AR. The mean follow-up duration after VSD repair was 6.6 ± 4.0 years. In the latest follow-up echo after VSD repair, four patients had more than mild degree AR owing to aortic valve abnormalities or delayed operation period. Among them, AR progression occurred in only one patient (0.98%). Early and accurate assessment of the anatomical morphology of the aortic valve and optimal operation timing may be important to achieve better outcomes after repair and to prevent the development of aortic valve complications.

Mid-term results of percutaneous ventricular septal defect closure with Amplatzer Duct Occluder-II in children

2017 ◽  
Vol 27 (9) ◽  
pp. 1726-1731 ◽  
Author(s):  
Ozge Pamukcu ◽  
Nazmi Narin ◽  
Ali Baykan ◽  
Suleyman Sunkak ◽  
Onur Tasci ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Defect Closure ◽  
Amplatzer Duct Occluder ◽  
Total Procedure Time ◽  
Study Centre ◽  
Ventricular Septal Defect Closure ◽  
The Mean ◽  
Mid Term Results

AbstractAimThe aim of this study was to share the mid-term results of percutaneous ventricular septal defect closure using Amplatzer Duct Occluder-II in children.BackgroundNowadays, percutaneous ventricular septal defect closure is accepted as an alternative to surgery, but so far no ideal device has been developed for this procedure.MethodsIn the study centre, between April, 2011 and October, 2016, the ventricular septal defect of 49 patients was closed percutaneously using the Amplatzer Duct Occluder-II device, and seven of them were <1 year old.ResultsThe mean age of patients was 86.8±52.6 months. The mean weight of the patients was 24.3±16 kg. The mean diameter of the defect was 3.7±1.4 mm. Mean fluoroscopy time and total procedure time were 37±19.3 and 74.1±27 minutes, respectively. The types of ventricular septal defects were muscular in six patients, and were perimembranous in the rest of them. We did not face any major complications during the procedure, but one patient was admitted with a complete atrioventricular block in the 6th month of follow-up. The total follow-up period was 66 months.ConclusionTo our knowledge, our study includes the largest series of paediatric patients whose ventricular septal defect was closed using Amplatzer Duct Occluder-II percutaneously. When the complications during the 66-month follow-up period are taken into consideration, we can state that Amplatzer Duct Occluder-II is a safe and effective device, even in infants aged <1 year.

The mid-term outcome of interventricular septal hematoma after ventricular septal defect closure

2021 ◽  
pp. 021849232110666
Author(s):  
Masaya Aoki ◽  
Yuki Ikeno ◽  
Keijiro Ibuki ◽  
Sayaka Ozawa ◽  
Keiichi Hirono ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Enzyme Inhibitor ◽  
Single Photon ◽  
Interventricular Septum ◽  
Photon Emission ◽  
Defect Closure ◽  
Low Cardiac Output Syndrome ◽  
Ventricular Septal Defect Closure

We present the case report of a patient who developed interventricular septal hematoma as a complication during perimembranous ventricular septal defect closure. Although cardiopulmonary bypass was re-established and the hematoma was aspirated, postoperative echocardiography revealed that the hematoma reaccumulated in the interventricular septum. She suffered from low-cardiac-output syndrome for 1 week requiring a large amount of inotropic agents. Postoperative echocardiography revealed that the interventricular septal hematoma gradually disappeared. At 1 year follow-up, 99mTc-tetrofosmin myocardial single-photon emission computed tomographic revealed myocardial ischemia in the inferior and septal walls. At 4 years follow-up, her cardiac function has gradually improved. She has no symptoms of heart failure with angiotensin-converting enzyme inhibitor and beta-blocker.

scholarly journals CLINICAL AND ECHOCARDIOGRAPHIC FOLLOW-UP AFTER SURGICAL VENTRICULAR SEPTAL DEFECT CLOSURE IN ADULTS

2010 ◽  
Vol 55 (10) ◽  
pp. A41.E396
Author(s):  
François-Pierre Mongeon ◽  
Harold M. Burkhart ◽  
Naser M. Ammash ◽  
Joseph A. Dearani ◽  
Zhuo Li ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Defect Closure ◽  
Ventricular Septal Defect Closure
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