Device closure of ventricular septal defect: Initial experience in Nepal

Abstract

Background: Device closure is an attractive alternative in the management of Ventricular Septal defect (VSD).
 Aims and Objective: The aim of the study was to access the safety and early outcome of VSD device closure at Shahid Gangalal National Heart Centre, Nepal.
 Materials and Methods: The study was single center, retrospective study. All the VSD cases who were attempted for VSD device closure during December 2016 to February 2019 were included. Catheterization laboratory records for VSD type and size, Device type and size were retrospectively reviewed. Hospital records were reviewed for in-hospital complications. 
 Results: Sixty-one VSD cases were attempted for device closure. VSD was successfully closed in 55 (90.1%) patients. The mean age of the patient was 11.1 years. Twenty-nine (52.7%) were female and 26 (47.3%) were male. Perimembranous VSD in 49 (89 %) and muscular VSD in 6 (11 %) patients. The size of VSD ranged between 2 and 12mm (Mean 5.4mm). The VSD was closed with Amplatzer duct occluder I, Amplatzer duct occluder II, Amplatzer muscular VSD occluder and Memopart PDA device in 24 (43.7%), 26 (47.3%), 4 (7.2 %) and one patient (1.8%) patients respectively. The postoperative complications were insignicant residual leak across device in 2 (3.6%) patients, mild pericardial effusion in one (1.8%) patient. None of the patient had new onset tricuspid regurgitation, aortic regurgitation and complete heart block. One patient developed Right bundle branch block, one developed Left bundle branch block, one developed Junctional rhythm. There was no mortality.
 Conclusion: VSD device closure can be safe and effective if patients are selected properly.

Transcatheter Device Closure of Ventricular Septal Defect in Children: A Retrospective Study at Pediatric Cardiac Center, Children’s Hospital, Ain Shams University

“…The present study showed that, according to VSD types, 19 cases (54.3%) were perimembranous, 12 cases (34.3 %) were muscular and 4 cases (11.4%) were basal muscular. This is in agreement with Adhikari et al (8) who reported that there was perimembranous VSD in 49 cases (89%) and muscular VSD in 6 (11%) patients. While, in the study of Khoshhal et al (1) they reported that 68.6% of the studied children had muscular VSD and 31.4% were diagnosed by perimembranous VSD.…”

“…18 cases (51.4%) of the study population were females and 17 cases (48.6%) of the study population were males. In Adhikari et al (8) study, they reported that the mean age of the patient was 11.1 years. 29 (52.7%) were females and 26 (47.3%) were males.…”

Late Aortic Insufficiency After Ventricular Device Closure: A Case Report

“…As studies have shown low mortality and morbidity with the percutaneous approach, device closure of VSDs has been gaining more attention. [4,5] With the availability of different devices, the range of closure had been expanded from muscular to perimembranous and subarterial VSDs. Among various complications associated with device closure, aortic regurgitation is considered to be rare.…”

The Spectrum of Congenital Heart Diseases Operated at Shahid Gangalal National Heart Center in the last 5 Years.

“…17 Cardiologists, at our center are performing significant number of transcatheter closure of ASD as well as VSD. 18,19 Overall, the impact of transcatheter closure of isolated cardiac lesion to the number of surgical closure in our center is not studied yet.…”