A New Coated Nitinol Occluder for Transcatheter Closure of Ventricular Septal Defects in a Canine Model

Aims. This study evaluated feasibility and safety of implanting the polyester-coated nitinol ventricular septal defect occluder (pcVSDO) in the canine model.Methods and Results. VSD models were successfully established by transseptal ventricular septal puncture via the right jugular vein in 15 out of 18 canines. Two types of VSDOs were implanted, either with pcVSDOs (n=8) as the new type occluder group or with the commercial ventricular septal defect occluders (VSDOs,n=7, Shanghai Sharp Memory Alloy Co. Ltd.) as the control group. Sheath size was 10 French (10 Fr) in two groups. Then the general state of the canines was observed after implantation. ECG and TTE were performed, respectively, at 7, 30, 90 days of follow-up. The canines were sacrificed at these time points for pathological and scanning electron microscopy examination. The devices were successfully implanted in all 15 canines and were retrievable and repositionable. There was no thrombus formation on the device or occurrence of complete heart block. The pcVSDO surface implanted at day 7 was already covered with neotissue by gross examination, and it completed endothelialization at day 30, while the commercial VSDO was covered with the neotissue in 30th day and the complete endothelialization in 90th day.Conclusion. The study shows that pcVSDO is feasible and safe to close canine VSD model and has good biocompatibility and shorter time of endothelialization.

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Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience

Cardiology in the Young ◽

10.1017/s1047951120000244 ◽

2020 ◽

Vol 30 (3) ◽

pp. 409-412

Author(s):

Murat Surucu ◽

İlkay Erdoğan ◽

Birgül Varan ◽

Murat Özkan ◽

N. Kürşad Tokel ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Right Ventricle ◽

Septal Defect ◽

Surgical Intervention ◽

Systolic Pressure ◽

Presenting Symptoms ◽

Long Term Follow Up ◽

The Right

AbstractObjective:Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery.Methods:We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated.Results:Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1).Conclusion:The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.

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Staged Correction of Pulmonary Atresia, Ventricular Septal Defect and Collateral Arteries

10.22541/au.163275129.98299783/v1 ◽

2021 ◽

Author(s):

Pieter van de Woestijne ◽

M. Mokhles ◽

Ingrid van Beynum ◽

Peter de Jong ◽

Jeroen Wilschut ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Pulmonary Arteries ◽

Pulmonary Atresia ◽

Pulmonary Vasculature ◽

Collateral Arteries ◽

Staged Approach ◽

The Right ◽

Rv Function

Objectives Pulmonary atresia (PA) with ventricular septal defect (VSD) and systemic-pulmonary collateral arteries (SPCA’s) has a variable anatomy with regard to the pulmonary vasculature, asking for an individualized surgical treatment. A protocol was applied consisting of staged unifocalization and correction. Methods Since 1989 39 consecutive patients were included (median age at first operation 13 months). In selected cases a central aorto-pulmonary shunt was performed as first procedure. Unifocalization procedures were performed through a lateral thoracotomy. Correction consisted of shunt takedown, VSD closure and interposition of an allograft between the right ventricle and the reconstructed pulmonary artery. Postoperatively and at follow up echocardiographic data were obtained. Results In 39 patients 66 unifocalization procedures were performed. Early mortality was 5%. Seven patients were considered not suitable for correction, four of them died. One patient is awaiting further correction. Correction was done successfully in 28 patients. Operative mortality was 3% and late mortality 11%. Median follow-up after correction was 19 years. Eleven patients needed homograft replacement. Freedom from conduit replacement was 88%, 73% and 60% at 5, 10 and 15 years respectively. Right ventricular function was reasonable or good in 75 % of the patients. Conclusions After complete unifocalization 30/37 patients (81%) were considered correctable. The main reasons for palliative treatment without correction were pulmonary hypertension and/or inadequate outgrowth of pulmonary arteries. Staged approach of PA, VSD and SPCA’s results in adequate correction and good functional capacity. RV function after correction remains reasonable or good in the majority of patients.

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Effect of the Use of WeChat to Disseminate Preoperative Health Education to Parents of Children with Restrictive Ventricular Septal Defects: A Prospective Randomized Controlled Study

The Heart Surgery Forum ◽

10.1532/hsf.3323 ◽

2020 ◽

Vol 23 (6) ◽

pp. E897-E901

Author(s):

Qiliang Zhang ◽

Ning Xu ◽

Shuting Huang ◽

Qiang Chen ◽

Hua Cao

Keyword(s):

Health Education ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Preoperative Care ◽

Randomized Controlled Study ◽

Controlled Study ◽

Control Group ◽

Loss To Follow Up ◽

Randomized Controlled

Background: This study explored the clinical effect of implementing WeChat-based preoperative health education for parents of children with restrictive ventricular septal defect. Methods: A prospective randomized controlled study was conducted in a provincial hospital on the southeast coast of China. Participants were randomly divided into an intervention (WeChat) group (n = 35) and a control group (leaflet) group (n = 35). The study explored the parents’ knowledge of preoperative care, the follow-up rate, and complications of children with restrictive ventricular septal defect. Results: The score of preoperative care knowledge of the WeChat group (66.9 ± 3.5) was significantly higher than that of the leaflet group (47.3 ± 6.3) (P = .006). Compared with the score of care knowledge at the first visit, the score of the WeChat group at the preoperation was significantly higher (P < .05), whereas the increase in the score of the leaflet group was not significant. The rate of lost follow-up in the WeChat group (0%) was significantly lower than in the leaflet group (16.7%) (P = .02). The complications in the leaflet group were significantly higher than in the WeChat group. Conclusions: Using WeChat to provide preoperative health education to parents of children with restrictive ventricular septal defect can effectively enhance the parents’ knowledge of preoperative care and reduce the occurrence of complications and loss to follow-up.

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Surgery for Aortic Insufficiency Associated with Ventricular Septal Defect

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300114 ◽

2005 ◽

Vol 13 (1) ◽

pp. 61-64 ◽

Cited By ~ 3

Author(s):

Chareonkiat Rergkliang ◽

Vorawit Chittithavorn ◽

Apirak Chetpaophan ◽

Prasert Vasinanukorn

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Aortic Insufficiency ◽

Aortic Cusp ◽

The Mean ◽

Coronary Cusp ◽

The Right ◽

Right Coronary Cusp

Aortic valve repair in children is a challenge. We have adopted a technique of single aortic cusp extension with an autologous pericardial strip in patients diagnosed with severe aortic insufficiency (AI) associated with a ventricular septal defect (VSD). The purpose of this study was to report the short-term outcomes. Seven patients were operated on between January 2002 and December 2003. The mean age was 11.28 ± 2.1 years (range 8–14 years). The VSD was closed with a synthetic patch. Aortic cusp extension was performed at the right coronary cusp in 6 patients and the remainder had a non-coronary cusp extension. The mean diastolic arterial pressure increased from 35.71 ± 6.09 to 74.28 ± 7.31 mm Hg after the operation ( p < 0.001). The postoperative grade of AI was trivial in 4 patients, mild in 1 patient and non-existent in 2 patients. The mean follow-up period was 12.85 ± 6.12 months (range 2–20 months). This technique is very effective in patients with severe AI associated with a VSD. However, long-term durability will need to be carefully followed.

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Animal Experimental Study of the Fully Biodegradable Atrial Septal Defect (ASD) Occluder

Journal of Biomedicine and Biotechnology ◽

10.1155/2012/735989 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 14

Author(s):

Yu-feng Zhu ◽

Xin-miao Huang ◽

Jiang Cao ◽

Jian-qiang Hu ◽

Yuan Bai ◽

...

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Thrombus Formation ◽

Gross Anatomy ◽

Interatrial Septum ◽

Canine Model ◽

Short Term ◽

Animal Experimental Study ◽

Brockenbrough Needle

This study was conducted to evaluate the feasibility, safety, biocompatibility, and degradation features of a fully biodegradable occluder for closure of atrial septal defect (ASD) in an acute canine model. The ASD was created in 20 healthy mongrel dogs by the brockenbrough needle, and the fully biodegradable occluders were implanted by self-made delivery system. The success rate and complications were observed. Acute ASD models were successfully created in 18 dogs, and 16 occluders were successfully implanted in the ASD models. Animals were sacrificed at different times after procedure. The cardiac gross anatomy showed that all occluders were stable in the interatrial septum, no vegetation or thrombus formation was observed on the surface of all occluders. They were embedded into endogenous host tissue gradually at 12-week follow-up. Different periods of pathological observations suggested that the occluders degraded gradually over about 24 weeks and essentially became an integral part of the septum. Transcatheter closure of ASD in acute canine model using the fully biodegradable ASD occluder has the potential of a high successful rate of technique, excellent biocompatibility, and fewer complications with adequate, immediate, and short-term results.

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

Cardiology in the Young ◽

10.1017/s1047951121002985 ◽

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.

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Quadruple Valve Replacement with Mechanical Valves: An 11-Year Follow-up Study

The Heart Surgery Forum ◽

10.1532/hsf98.20111124 ◽

2012 ◽

Vol 15 (3) ◽

pp. 145 ◽

Cited By ~ 5

Author(s):

Yukun Cao ◽

Chunhu Gu ◽

Guocheng Sun ◽

Shiqiang Yu ◽

Hongbing Wang ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Valve Replacement ◽

Heart Valves ◽

Septal Defect ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Follow Up Study ◽

Mechanical Valves ◽

The Right

Background: We performed the first quadruple valve replacement with mechanical valves, combined with the correction of complex congenital heart disease on November 17, 1999. We report here the 11-year follow-up study.Methods: A 47-year-old man with subacute rheumatic endocarditis, a ventricular septal defect, and an obstruction of the right ventricular outflow tract required replacement of the aortic, mitral, tricuspid, and pulmonary valves; repair of the ventricular septal defect; and relief of the obstruction of the right ventricular outflow tract. The surgery was done on November 17, 1999, after careful systemic preparation of the patient. Warfarin therapy with a target international normalized ratio (INR) range of 1.5 to 2.0 was used. Follow-up included monitoring the INR, recording the incidences of thromboembolic and bleeding events, electrocardiography, radiography, and echocardiography evaluations.Results: The patient's INR was maintained between 1.5 and 2.0. All 4 mechanical prosthetic heart valves worked well. He is in generally good health without any thromboembolic or bleeding complications.Conclusions: Long-term management is challenging for patients who have experienced quadruple valve replacement with mechanical valves; however, promising results could mean that replacement of all 4 heart valves in 1 operation is feasible in patients with quadruple valve disease, and an INR of 1.5 to 2.0 could be appropriate for Chinese patients with undergoing valve replacement with mechanical valves.

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Thrombosis after umbilical venous catheterisation: prospective study with serial ultrasound

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2018-316762 ◽

2019 ◽

Vol 105 (3) ◽

pp. 299-303 ◽

Cited By ~ 4

Author(s):

Gerdina H Dubbink-Verheij ◽

Remco Visser ◽

Arno A Roest ◽

Cornelia Heleen van Ommen ◽

Arjan B te Pas ◽

...

Keyword(s):

Prospective Observational Study ◽

Thrombus Formation ◽

Expectant Management ◽

Ductus Venosus ◽

Control Group ◽

Umbilical Catheters ◽

The Right ◽

Lost To Follow Up ◽

Umbilical Catheterisation

BackgroundUmbilical venous catheters (UVCs) are associated with thrombus formation. Most studies on thrombosis in infants with UVCs focus on only one part of the route, and none assessed a control group of infants without UVCs.ObjectiveTo determine the incidence and location of thrombi in infants after umbilical catheterisation and compare this with a control group of infants without umbilical catheters.DesignProspective observational study with serial ultrasonography of the UVC route from the umbilico-portal confluence to the heart. Ultrasonography was performed until day 14 after catheterisation in cases and day 14 after birth in controls.ResultsThrombi in the UVC route were detected in 75% (30/40) of infants with UVCs in the study group, whereas no thrombi were detected in the control group of infants without UVCs (0/20) (p<0.001). Six thrombi (20%) were located in the right atrium. Most of these were also partly present in the ductus venosus. Six thrombi (20%) were located in the ductus venosus only, and in 12 infants (40%), the thrombus was at least partly located in the umbilico-portal confluence. Thrombi persisted after UVC removal in 25/30 cases. Two infants with thrombotic events were treated with low-molecular-weight heparin and resolution was found. In the other 23 infants managed expectantly, 2 died due to necrotising enterocolitis, 1 was lost to follow-up and in 20 spontaneous regression was seen.ConclusionsThrombotic events occur frequently in infants after umbilical catheterisation. Most thrombi were asymptomatic and regressed spontaneously with expectant management. Routine screening for thrombi in UVCs is therefore not advised.

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

Cardiology in the Young ◽

10.1017/s1047951100010854 ◽

1994 ◽

Vol 4 (1) ◽

pp. 44-50 ◽

Cited By ~ 1

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.

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