Percutaneous closure of perimembranous ventricular septal defect using patent ductus arteriosus occluders

Nguyen, Hieu Lan; Phan, Quang Tan; Doan, Dung Duc; Dinh, Linh Huynh; Tran, Hieu Ba; Sharmin, Saima; Thottian, Julian Johny; Won, Hoyoun; Lee, Wang Soo; Shin, Seung Yong; Nguyen, Truong Q.; Kim, Sang‐Wook

doi:10.1371/journal.pone.0206535

Cited by 21 publications

(23 citation statements)

References 45 publications

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“…In our experience, results of transcatheter VSD closure with Amplatzer occluders were satisfactory: the procedure was successfully performed in 98% of cases, confirming the results reported in other published studies (4, 5). However, closure rate was only 89.8% at six months of follow-up when compared to higher previous reports (36, 37, 41). In fact, some procedure related complications are reduced with precise defect sizing and proper device selection (42, 43).…”

Section: Discussioncontrasting

confidence: 78%

Device Closure of Perimembranous Ventricular Septal Defect: Choosing Between Amplatzer Occluders

2019

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Background: Off-label device closure of perimembranous ventricular septal defect (pmVSD) is well reported in the literature with encouraging results. However, technical challenges may be encountered. Objectives: To evaluate and compare feasibility, technical aspects, procedural outcomes, and mid-term follow-up of pmVSD closure using Amplatzer™ occluders. Patients and Methods: From July 2015 to July 2018, patients in whom pmVSD closure was attempted using an Amplatzer occluder were retrospectively identified from our institution's database. Device selection was made according to the defect anatomy that was obtained via ventriculography and trans-esophageal echocardiography. Follow-up evaluations were done at discharge, then at 1, 3, 6, and 12 months and yearly thereafter with transthoracic echocardiography and electrocardiogram. Results: In total, 8 Amplatzer Duct Occluder (ADO), 27 ADO II, and 17 Amplatzer Muscular VSD Occluder (AMO) were used in 51 patients with a mean age of 7.4 ± 6.9 years and a mean weight of 25.4 ± 19.8 kg. Implantation was successful in 50/51 patients (98.0%). There was no procedure related mortality. One ADO accidentally embolized to the aorta after release and was surgically recaptured from the iliac artery. All ADO II were delivered retrogradely with the least amount of time ( p = 0.002) and the lowest radiation exposure ( p < 0.001). Minor valvular disturbances occurred in 8/49 patients (16.3%), including five tricuspid regurgitation (three with ADOII and two with AMO) and three trivial aortic regurgitations (two with ADO and one with ADOII). On a median follow-up of 194 days (range, 60–895 days), no surgical device removal was necessary. At 6 months of follow-up, trivial residual shunt was present in 5/49 patients (10.2%), among which none occurred with ADO. One complete atrioventricular block was detected 18 months after ADO implantation and required permanent pacing. Conclusions: Transcatheter closure of PmVSD using Amplatzer occluders is feasible, safe and efficacious in properly selected patients. The major key factor behind high procedural success rate is proper device selection. ADOII is remarkably superior in terms of device softness, flexibility and faster implantation process. Yet, its use is limited to small defects with particular anatomy.

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Section: Discussioncontrasting

confidence: 78%

Device Closure of Perimembranous Ventricular Septal Defect: Choosing Between Amplatzer Occluders

2019

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“…Recently, Nguyen et al published a multicenter case series of antegrade transvenous closure of PMVSD using ADO I with 95% success rate and with complications in 1.7% of cases. They had embolization of device in 1% of cases and AVB in 0.7% of cases [16].…”

Section: Comment On This Article or Ask A Questionmentioning

confidence: 99%

Transcatheter Trans-aortic Retrograde Approach for the Closure of Perimembranous Ventricular Septal Defects using Cocoon [Amplatzer Duct Cccluder I Like] Device – An Initial Experience from a Single Centre

Jariwala¹,

Narayanan²,

Kumar³

2019

jshd

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Aims & Objective: Transcatheter ventricular septal defect (VSD) device closure is usually performed using the antegrade approach [1-3]. A few case series of a retrograde technique using the Amplatzer duct occluder (ADO) II device have been reported [4, 5]. We aimed to assess the feasibility and safety of a retrograde closure technique using an ADO I like device, which is used for the closure of patent ductus arteriosus (PDA). Methods: Between June 2015 and January 2018, eight consecutive, consenting cases with congenital perimembranous VSDs underwent trans-aortic device closure using an ADO I like device in a single tertiary care center. Results: The median age was 17.1 years (5-32, SD 17.125 years) with 3 males and 5 females. Mean defect size was 6.6 mm (4.5-8.6 mm, SD 6.6125), with a median aortic rim of 3.4 mm (2-5, SD 3.4125). Median Qp/Qs and right ventricular systolic pressure was 1.8 (1.6-2.1, SD 1.825) and 41.3 mm Hg (33-50, SD 41.25) respectively. Median fluoroscopy and procedure times were 13.3 (10.6-15.7, SD 13.275) and 23.5 (18.2-27.2, SD 22.722) minutes respectively. The defects were successfully closed with no residual shunt in all 8 patients (100%). There was no

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“…[42] Device closure of VSDs has become more common and can be performed safely and effectively. [43] Only muscular VSD closure is FDA approved. Since the introduction of the Amplatzer devices to close VSDs in 1998, the outcomes of percutaneous VSD closure have significantly improved and results have been promising as these were specifically designed for closure of VSDs.…”

Section: Congenital Defectsmentioning

confidence: 99%

“…Since the introduction of the Amplatzer devices to close VSDs in 1998, the outcomes of percutaneous VSD closure have significantly improved and results have been promising as these were specifically designed for closure of VSDs. [43] The wide variability in VSD location, size and morphology led to the development of different designs of the Amplatzer VSD devices ( Figure 3 ). Other non-Amplatzers devices are also available for use.…”

Section: Congenital Defectsmentioning

confidence: 99%

State-of-the-art Structural Interventions in Heart Failure

Park

Suradi

2019

Card Fail Rev

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Heart failure (HF) is a leading cause of hospitalisation and healthcare costs worldwide. Acute decompensated heart failure accounts for more than 1 million hospitalisations in the US. Despite advances in the quality of acute and chronic HF disease management, gaps in knowledge about effective interventions to support the transition of care for patients with HF remain. Despite multiple trials of promising therapies, standard care consists of decongestion with IV diuretics and haemodynamic support with vasodilators and inotropes and this has remained largely unchanged during the past 45 years. Newer advances in medical innovations and structural heart disease interventions have now given promise to improved survival, outcomes and quality of life for patients with advanced HF of multiple aetiologies. In this article, we focus on structural interventions in the treatment of patients with HF.

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Percutaneous closure of perimembranous ventricular septal defect using patent ductus arteriosus occluders

Cited by 21 publications

References 45 publications

Device Closure of Perimembranous Ventricular Septal Defect: Choosing Between Amplatzer Occluders

Device Closure of Perimembranous Ventricular Septal Defect: Choosing Between Amplatzer Occluders

Transcatheter Trans-aortic Retrograde Approach for the Closure of Perimembranous Ventricular Septal Defects using Cocoon [Amplatzer Duct Cccluder I Like] Device – An Initial Experience from a Single Centre

State-of-the-art Structural Interventions in Heart Failure

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