The Feasibility and Safety of Interventional Occlusion Treatment of Intracristal Ventricular Septal Defects: Clinical Report of 56 Cases

Background: To investigate the feasibility and safety of the O eccentric shape occluder in the interventional occlusion treatment of intracristal ventricular septal defect (IVSD). Methods: A retrospective analysis of the clinical data of 56 IVSD patients treated by interventional occlusion at our center, as well as recording of their intraoperative and postoperative status, was performed. Results: Of the 56 patients, a total of 48 patients underwent successful occlusion during the first surgical attempt. Four patients were transferred to the Surgery Department after occlusion when the largest occluder failed because of large defects. Two patients exhibited aortic valve regurgitation; 1 patient had mild regurgitation, which was not worsened after 6 months of follow-up. One patient had severe aortic regurgitation, and 2 days after the operation, the patient underwent a second operation. One patient exhibited a residual shunt, which was above the occluder; after 1 year of follow-up, re-occlusion was successful and eliminated the shunt. One patient developed complete right bundle branch block. Conclusion: Most IVSD interventional occlusion treatments are feasible and safe.

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Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

10.21203/rs.2.16046/v2 ◽

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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Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

10.21203/rs.2.16046/v3 ◽

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

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Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up

BMC Surgery ◽

10.1186/s12893-020-00854-0 ◽

2020 ◽

Vol 20 (1) ◽

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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Temporary Tricuspid Valve Detachment for Ventricular Septal Defect Closure: Is It Worth Doing It?

The Heart Surgery Forum ◽

10.1532/hsf98.20121111 ◽

2015 ◽

Vol 16 (2) ◽

pp. 99

Author(s):

Alexander Weymann ◽

Stanimir Georgiev ◽

Carsten Vogelsang ◽

Annette Ivad ◽

Matthias Karck ◽

...

Keyword(s):

Tricuspid Valve ◽

Septal Defect ◽

Control Group ◽

Ventricular Septal Defects ◽

Residual Shunt ◽

Septal Defects ◽

Ventricular Septal Defect Closure ◽

Potential Risks ◽

Valve Detachment

Background: Tricuspid valve detachment (TVD) may improve the access for closing certain ventricular septal defects (VSDs), but it has some potential risks. We aimed to study the benefits and drawbacks of this technique.Methods: The midterm outcomes of all 20 patients who underwent a TVD closure for VSD were reviewed and compared with a control group of 15 patients with VSD closure without TVD.Results: There was no significant residual shunt in either group at the last actuarial follow-up. Tricuspid regurgitation occurred in both groups (45% in the TVD group and 27% in the control group, P = .48). These lesions were considered insignificant in all patients. There were no atrioventricular blocks, and all patients were in sinus rhythm. The cardiopulmonary bypass times were significantly higher in the TVD group than in the control group (91.6 � 17.2 minutes versus 68.3 � 15.7 minutes, P ? .01), as were the aortic cross-clamping times (50.7 � 12.1 minutes versus 35.9 � 14.4 minutes, P ? .01).Conclusion: Our results, along with results from other series, suggest that TVD can be used effectively and safely for closure of certain VSDs.

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Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

10.21203/rs.2.16046/v1 ◽

2019 ◽

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 are totally 54 patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5 years follow-up. Results: Closure was successful in 53 patients (98.1%). There was no mortality, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient who 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), one unsuccessful cases needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be efficacious. Close monitoring for bleeding is very necessary postoperatively especially in younger patients. This technique is generally safe in selected group of patients with acceptable mid-term outcomes. Keywords: Ventricular septal defect; Device closure; Minimally invasive surgery

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Transcatheter closure as standard treatment for most interatrial defects: experience in 200 patients treated with the Amplatzer ™ Septal Occluder

Cardiology in the Young ◽

10.1017/s1047951100005369 ◽

1999 ◽

Vol 9 (5) ◽

pp. 468-473 ◽

Cited By ~ 145

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.

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Clinical course in children and adolescents with ventricular septal defect

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492319867001 ◽

2019 ◽

Vol 27 (7) ◽

pp. 529-534

Author(s):

Noor Mohammad Noori ◽

Alireza Teimouri

Keyword(s):

Pulmonary Hypertension ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Clinical Course ◽

Defect Size ◽

Eisenmenger Syndrome ◽

Ventricular Septal Defects ◽

Laboratory Findings ◽

Septal Defects

Background Ventricular septal defect, the most common congenital heart defect, is characterized by an opening between the ventricles. This study aimed to evaluate the clinical course and associations between the characteristics of ventricular septal defect. Methods This cross-sectional study was conducted on 1498 children with ventricular septal defects, aged <19 years, who were referred to our center between 2003 and 2018. The diagnosis was suspected from a combination of clinical and laboratory findings, and confirmed by transthoracic echocardiography. Results Of the 1498 children, 54.9% were boys, 78.4% of defects were perimembranous, 30.4% of patients had pulmonary hypertension, 67.5% had regular follow-up, and 76 (5.1%) had complications including 28 (1.9%) with Eisenmenger syndrome; 10 died due to Eisenmenger syndrome during follow-up. The defects closed spontaneously in 38.9% and after surgery in 20.9%. Boys tended to have more perimembranous, inlet, and outlet forms (56.40%, 50.60%, 51.90%, respectively), whereas girls had more muscular types (51.80%). Most patients with pulmonary hypertension had perimembranous defects (83.10%). The majority of patients with pulmonary hypertension had large (63.40%) or moderate (36.60%) defects. Pulmonary hypertension had a significant association with defect size ( p < 0.001). After surgery, residual defects were found mostly in cases of large defects (84.60%). Most patients with spontaneous closure were younger than 4 years. Conclusion Almost four-fifths of children with ventricular septal defects had perimembranous types, and almost one-third had pulmonary hypertension which was associated with defect size. Two-fifths of the defects closed spontaneously. There was a low incidence of complications after surgery.

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

10.22541/au.163275137.78829535/v1 ◽

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.

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Congenital heart disease in 37,294 births in Tunisia: birth prevalence and mortality rate

Cardiology in the Young ◽

10.1017/s1047951113001194 ◽

2013 ◽

Vol 24 (5) ◽

pp. 866-871 ◽

Cited By ~ 18

Author(s):

Dorra Abid ◽

Anis Elloumi ◽

Leila Abid ◽

Souad Mallek ◽

Hajer Aloulou ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Septal Defect ◽

Pulmonary Atresia ◽

Coarctation Of The Aorta ◽

Ventricular Septal Defects ◽

Birth Prevalence ◽

Septal Defects

AbstractAim: To investigate the previously unknown birth incidence, treatment, and mortality of children with congenital heart disease in Tunisia. Methods: We undertook a retrospective review of medical records of all patients who were born in 2010 and 2011, and were diagnosed in Sfax (Tunisia) with congenital heart defect. Results: Among 37,294 births, 255 children were detected to have congenital heart disease, yielding a birth incidence of 6.8 per 1000. The most frequently occurring conditions were ventricular septal defects (31%), ostium secundum atrial septal defects (12.9%), and pulmonary valve abnormalities (12%). Coarctation of the aorta, tetralogy of Fallot, univentricular physiology, pulmonary atresia with ventricular septal defect, and transposition of the great arteries were found in 4.3%, 6.2%, 3.4%, 2.7%, and 2.7%, respectively. During the follow-up of 1 year, 23% of the children died. About three-quarters of those deaths happened before surgery. Conclusion: The present study is in line with the general estimates in the world. It has revealed a high case of mortality among the patients awaiting corrective surgery. These children need more facilities.

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Experience in one centre using the buttoned device for occlusion of atrial septal defect: comparison with the Amplatzer septal occluder

Cardiology in the Young ◽

10.1017/s1047951100008222 ◽

2000 ◽

Vol 10 (5) ◽

pp. 527-533 ◽

Cited By ~ 12

Author(s):

François Godart ◽

Christian Rey ◽

Charles Francart ◽

Marie André Cajot ◽

Georges Marie Brevière ◽

...

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Fluoroscopy Time ◽

Amplatzer Septal Occluder ◽

Residual Shunt ◽

Complete Occlusion ◽

Septal Defects ◽

Amplatzer Occluder ◽

Immediate Surgery

AbstractWe report our experience using the buttoned device to close defects within the oval fossa and probe-patent oval foramens, comparing the findings with those obtained with the Amplatzer septal occluder. from 1992 to 1997, we used the buttoned device to close defects in 73 consecutive patients, 64 with defects in the oval fossa and nine with patent foramens. We compared this experience with a further series of 62 patients seen from 1997 to 1999 in whom the Amplatzer septal occluder was used. Successful implantation was achieved in three-quarters of those with septal defects in whom the buttoned device was used, in all of those in whom the buttoned device was used for patent foramens, and in nine-tenths of those in whom closure was attempted using the Amplatzer occluder. Immediate surgery was needed in 3 patients in whom a buttoned device was used, one because of embolization and two with residual shunts and a straddling device. Similar immediate surgery was needed to retrieve one embolized Amplatzer occluder. During follow-up, surgery was needed in a further 7 patients, all having had insertion of a buttoned device, because of atrial perforation in one and a significant residual shunt in the remainder. At late follow-up, the rate of complete occlusion was 69% in the patients in whom the buttoned device was used to close a septal defect, 100% when the buttoned device was used for patent foramens, and 95% in those treated with the Amplatzer occluder. Our experience shows that the Amplatzer occluder produced a significantly higher rate of occlusion for larger defects, and with a shorter fluoroscopy time than the buttoned device. The Amplatzer septal occluder, therefore, is our preferred device for closure of defects within the oval fossa.

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