Percutaneous closure of perimembranous ventricular septal defects utilizing almost ideal Amplatzer Duct Occluder II: Why limitation in sizes?

Abstract

Aim:The purpose of this study is to describe the special aspects of perimembranous ventricular septal defects (pmVSD) closure by utilizing Amplatzer Duct Occluder II (ADO II) devices with a rational request for bigger ADO-II sizes, based on our experience in transcatheter device closure of pmVSD. Methods and Results: At our institution, placement of an ADO II device was used in 15 patients with pmVSD; the patients' age ranged between 6 months and 20 years.The indications for closure were CHF (n = 4), hemodynamically significant shunt (n = 7), tricuspid regurgitation (n = 3), and high risk for infective endocarditis (n = 2), respectively. The location of the VSD was infracristal in 13 patients, supracristal in 1, and a postsurgical Gerbode VSD in another one. Implantation of the device was successfully performed without embolization, any evidence of an AV block, or other conductance abnormalities during implantation and follow-up in the mean of 2.5 years (range 2 months-6.5 years). Conclusions: Transcatheter closure of a pmVSD with ADO II is feasible in all pediatricand young adult age groups, by considering the device diameter limitations. The offlabel use of ADO II implantation seems to be safe for VSDs closure up to 6 mm of size and feasible for various locations including unusual morphology such as postsurgical Gerbode defect. K E Y W O R D SAmplatzer Duct Occluder II, pediatric, perimembranous ventricular septal defect, transcatheter closure

Safety and Efficacy of Transcatheter Occlusion of Perimembranous Ventricular Septal Defect with Aortic Valve Prolapse: A Six-Year Follow-Up Study

“…e most serious arrhythmia is complete atrioventricular block, with an incidence of 1% to 5% [19][20][21]. ose who cannot recover after treatment with methylprednisolone or temporary pacemaker need permanent pacemaker treatment [22].…”

Cierre percutáneo de defecto tipo Gerbode en un niño de 3 años tras cirugía de Bentall

“…Se opta por el cierre percutáneo al tener experiencia en el cierre de las comunicaciones interventriculares (CIV) perimembranosas con el oclusor ADO II y porque la técnica para cerrar los defectos de Gerbode es la misma que para el cierre de la CIV perimembranosa (5). Se elige este dispositivo porque tiene un bajo perfil, por lo que necesita una vaina más pequeña que otros dispositivos, lo que supone una gran ventaja cuando se trata de pacientes pediátricos.…”

“…• Casos clínicos RETIC. 2020 (Mar); 3 (1): 23-26 cierre de la CIV y con la bibliografía, se elige un tamaño de dispositivo entre 0-1 mm mayor que el diámetro del defecto (5) . La mayor serie publicada de cierre de defectos de Gerbode congénitos también utiliza esta regla a la hora de escoger el tamaño del dispositivo (6) .…”

Efficacy and safety of the Amplatzer Duct Occluder II for ventricular septal defect closure: a meta-analysis

“…Complete atrioventricular block Cardiac dysrhythmias were other common complications, and cAVB was the most important among them. Nonetheless, the rate of cAVB in the 13 studies Esmaeili 18 El-Sisi 17 Fixed Overall…”

“…16 STATA version 15.0 (StataCorp LLC, College Station, Texas, United States) was used for all statistical analyses. results study characteristics A total of 150 studies were identified, of which 13 (with data for 478 participants) were included in this analysis (FiGURe 1) 7,8,10,11,[17][18][19][20][21][22][23][24] : 4 prospective studies, 4 retrospective studies, and 5 studies of uncertain types. The year of publication ranged from 2012 to 2019.…”