alexa Transcatheter closure of single muscular ventricular septal defects using the amplatzer muscular VSD occluder: initial results and technical considerations.


Journal of Clinical & Experimental Cardiology

Author(s): Hijazi ZM, Hakim F, AlFadley F, Abdelhamid J, Cao QL

Abstract Share this page

Abstract Surgical closure of multiple muscular ventricular septal defects (MVSDs) is associated with mortality and morbidity; therefore, both surgeons and cardiologists welcome a nonsurgical safe approach. We report our initial results of catheter closure of MVSD using the new Amplatzer muscular VSD occluder delivered via the venous or arterial routes. Eight patients with MVSD underwent closure of their VSDs using the Amplatzer VSD occluder under general endotracheal anesthesia. The mean +/- SD of age was 5.4 +/- 3.1 years (2-10 years) and mean weight was 18.4 +/- 6.5 kg (11.5-29 kg). All patients had left ventricular volume overload with mean Qp/Qs ratio of 1.7 +/- 0.6 (1.4-3). The location of the VSD was mid muscular in four, anterior in two, apical in one, and posterior in one. The systolic pulmonary artery pressure ranged from 25 to 85 mm Hg (mean, 39.9 +/- 18.8 mm Hg). The device was implanted successfully in all eight patients. In five patients (four mid muscular and one apical), the deployment of the device was anterograde from the right internal jugular vein and in three patients (two anterior and one posterior VSD), the initial attempt at anterograde deployment was unsuccessful due to kinking in the delivery sheath; therefore, retrograde deployment was attempted successfully. The size of the device used ranged from 6 to 14 mm (the size of the connecting waist). In patients with elevated pulmonary artery pressure, repeat measurements immediately after closure revealed normalization in all. There was immediate complete closure of the defect in two patients and six patients had trivial residual shunt (foaming through the device), which disappeared completely within 24 hr in five and at 6-month follow-up in the sixth patient. The mean fluoroscopy time was 37.1 +/- 13 min (11.7-55 min). Complications encountered included transient junctional rhythm in one patient. No blood transfusion was required. On follow-up evaluation, there has been no episode of endocarditis, thromboembolism, hemolysis, or wire disruption. we conclude that the Amplatzer MVSD occluder is a safe and effective device for closure of MVSDs up to 12 mm in diameter. Further clinical trials with this device are underway. Cathet. Cardiovasc. Intervent. 49:167-172, 2000. Copyright 2000 Wiley-Liss, Inc.
This article was published in Catheter Cardiovasc Interv and referenced in Journal of Clinical & Experimental Cardiology

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version