Closure of muscular ventricular septal defects: Transcatheter and hybrid techniques

As surgical and catheter interventions advance, patients with congenital heart disease are now offered alternative treatment options that cater to their individual needs. Furthermore, collaboration between interventional cardiologists and cardiac surgeons have led to the development of hybrid procedures, using the best techniques of each respective field to treat these complex cardiac entities from initial treatment in the pediatric patient to repeat intervention in the adult. We present a review of the increased popularity and trend in hybrid procedures in congenital heart disease without the use of cardiopulmonary bypass.

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“…(H) Complete deployment of the right disk with optimal device position. Reprinted with permission from publisher: John Wiley and Sons (29). …”

Section: Hybrid Vsd Closurementioning

confidence: 99%

“…Presently, the most popular devices used are the Amplatzer VSD Occluders (AGA Medical, Plymouth, MN, USA) (27–29). Off label use of Amplatzer duct occluders is also relatively common (30).…”

Section: Hybrid Vsd Closurementioning

confidence: 99%

Popular Hybrid Congenital Heart Procedures without Cardiopulmonary Bypass

Gupta

Amin

2017

Front. Surg.

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“…At the present, FDA has only approved Amplatzer muscular VSD occluder for transcatheter closure of muscular VSDs. Some large muscular VSDs in small babies may be closed by hybrid procedures via sternotomy and a purse-string suture in the right ventricle under transesophageal echo guidance (Amin et al 2008). No device is yet approved for closure of perimembranous VSD, presumably because of concern for development of heart block (Rao 2008).…”

Section: Managementmentioning

confidence: 99%

Congenital Heart Defects – A Review

Rao¹

2012

Congenital Heart Disease - Selected Aspects

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“…Muscular VSDs may cause clinical signs and symptoms of pulmonary overflow with left-sided volume overload. This may result in heart failure, especially in infants with hemodynamically significant unrestricted communications [2]. …”

Section: Introductionmentioning

confidence: 99%

“…This results in higher mortality and morbidity and increases the risk of reoperation and ventricular dysfunction due to right or left ventriculotomy [4]. Therefore, closure of small mVSDs with no hemodynamic compromise remains controversial, facing expected spontaneous closure of 80% of the defects in the first 2 years life [2]. Device closure of mVSDs can be successfully accomplished using transcatheter technique when the child reaches a body weight that allows intervention.…”

Section: Introductionmentioning

confidence: 99%

Hybrid approach for closure of muscular ventricular septal defects

Haponiuk¹,

Chojnicki²,

Jaworski³

et al. 2013

Med Sci Monit

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BackgroundThe complexity of ventricular septal defects in early infancy led to development of new mini-invasive techniques based on collaboration of cardiac surgeons with interventional cardiologists, called hybrid procedures. Hybrid therapies aim to combine the advantages of surgical and interventional techniques in an effort to reduce the invasiveness. The aim of this study was to present our approach with mVSD patients and initial results in the development of a mini-invasive hybrid procedure in the Gdansk Hybrid Heartlink Programme (GHHP) at the Department of Pediatric Cardiac Surgery, Pomeranian Centre of Traumatology in Gdansk, Poland.Material/MethodsThe group of 11 children with mVSDs was enrolled in GHHP and 6 were finally qualified to hybrid trans-ventricular mVSD device closure. Mean age at time of hybrid procedure was 8.22 months (range: from 2.7 to 17.8 months, SD=5.1) and mean body weight was 6.3 kg (range: from 3.4 to 7.5 kg, SD=1.5).ResultsThe implants of choice were Amplatzer VSD Occluder and Amplatzer Duct Occluder II (AGA Med. Corp, USA). The position of the implants was checked carefully before releasing the device with both transesophageal echocardiography and epicardial echocardiography. All patients survived and their general condition improved. No complications occurred. The closure of mVSD was complete in all children.ConclusionsHybrid procedures of periventricular muscular VSD closure appear feasible and effective for patients with septal defects with morphology unsuitable for classic surgical or interventional procedures. The modern strategy of joint cardiac surgical and interventional techniques provides the benefits of close cooperation between cardiac surgeon and interventional cardiologist for selected patients in difficult clinical settings.

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Closure of muscular ventricular septal defects: Transcatheter and hybrid techniques

Cited by 30 publications

References 19 publications

Popular Hybrid Congenital Heart Procedures without Cardiopulmonary Bypass

Popular Hybrid Congenital Heart Procedures without Cardiopulmonary Bypass

Congenital Heart Defects – A Review

Hybrid approach for closure of muscular ventricular septal defects

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