Transcatheter closure of congenital and acquired septal defects

Spies, Christian; Cao, Qi‐Ling; Hijazi, Ziyad M.

doi:10.1093/eurheartj/suq006

Cited by 11 publications

(8 citation statements)

References 88 publications

(86 reference statements)

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“…6 Perimembranous (PM) VSD accounts for 70-80% of all case. 7,8 Rest 20% are muscular VSDs of inlet, trabecular or infundibular type. 8 Large non-restrictive VSDs lead to congestive heart failure and severe pulmonary hypertension very early.…”

Section: Discussionmentioning

confidence: 99%

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Transcatheter closure of ventricular septal defect from retrograde transarterial approach: immediate and long-term outcome

Fatema

2020

Int J Contemp Pediatr

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Background: Ventricular septal defect (VSD) is a commonly encountered congenital heart defect. The aim of this study was to analyze five years’ experience with patients who had undergone transcatheter closure of VSD using retrograde transarterial approach.Methods: It was a retrospective study conducted from December 2014 to December 2019. Cases planned for VSD closure in retrograde approach were included. A total of 147 cases fulfilled the criteria after left ventricular angiography and procedure was performed without forming arteriovenous loop. Follow up was planned at 1, 3, 6, 12 months and yearly thereafter.Results: The mean age of the patients was 5.94±4.67 years and mean weight was 17.93±8.26 kg. Perimembranous VSD was present in 70.06% cases and the size of the VSD was 5.5±1.8 mm. Amplatzer duct occluder II was the commonest device used (55.24%). Mean device size was 6.2±1.8 (5-8 mm). Complete occlusion was achieved immediately in 94.56% cases, and after one month in 99.36% cases. Four (2.78%) cases were postponed for malpositioning and encroachment of aortic valve. One patient (2.22%) had tiny residual VSD up to 3 years follow up. Bacterial endocarditis was noticed in one patient (0.80%) at one year follow up. No evidence of complete heart block was encountered in follow up period of six to 60 months.Conclusions: This study recommends that retrograde transarterial approach for closure of moderate to small VSD is safe, effective, and minimally invasive, can be performed in short time with less radiation hazard and less trauma to conducting tissues.

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Section: Discussionmentioning

confidence: 99%

“…7,8 Rest 20% are muscular VSDs of inlet, trabecular or infundibular type. 8 Large non-restrictive VSDs lead to congestive heart failure and severe pulmonary hypertension very early. If left untreated they lead to Eisenmenger syndrome at very early stage.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of ventricular septal defect from retrograde transarterial approach: immediate and long-term outcome

Fatema

2020

Int J Contemp Pediatr

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“…A statement about the favorable imaging technique used to guide the procedure is lacking. In literature, echocardiographic imaging is generally named as additional imaging technique besides fluoroscopy to evaluate ASD anatomy [26]. Ewert et al had first published results on the feasibility of interventional ASD device closure without the use of fluoroscopy in a total of 26 patients in 1999 and 2000 [21, 22].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Atrial Septal Defect Closure in Children with and without Fluoroscopy: A Comparison

Ackermann

Quandt

Hagenbuch

et al. 2019

Journal of Interventional Cardiology

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Objective. The aim of this study was to compare feasibility, effectiveness, safety, and outcome of atrial septal defect (ASD) device closure in children with and without fluoroscopy guidance. Methods and Results. Children undergoing transcatheter ASD closure between 2002 and 2016 were included into this single center, retrospective study. Patients were analysed in two groups [1: intraprocedural fluoroscopy ± transoesophageal echocardiography (TOE) guidance; 2: TOE guidance alone]. Three-hundred-ninety-seven children were included, 238 (97 male) in group 1 and 159 (56 male) in group 2. Two-hundred-twenty-nine of 238 (96%) patients underwent successful fluoroscopy guided ASD closures versus 154/159 (97%) successful procedures with TOE guidance alone. Median weight (IQR) at intervention was 20kg (16.0-35.0) in group 1 versus 19.3kg (16.0-31.2) in group 2. Mean (SD) preinterventional ASD diameter was 12.4mm (4.4) in group 1 versus 12.2mm (3.9) in group 2. There was no significant difference in number of defects or characteristics of ASD rims. Median procedure time was shorter in group 2 [60min (47-86) versus 34min (28-44)]. Device-size-to-defect-ratio was similar in both groups [group 1: 1.07 versus group 2: 1.09]. There were less technical intraprocedural events in group 2 [10 (6.3%) versus 47 (20%)]. Intraprocedural complications were less frequent in group 2 [1 (0.6%) versus 8 (3.3%)]. Conclusion. Transcatheter ASD device closure with TOE guidance alone (i.e., without fluoroscopy) is as effective and safe as ASD closure with fluoroscopy guidance. As fluoroscopy remains an important adjunct to transoesophageal echocardiography, especially in complex defects and complications, procedures are always performed in a fully equipped cardiac catheterization laboratory.

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“…Post-op or iatrogenic VSDs are rare complications; most of them are residual shunts after aortic or VSD surgeries 1 . However, the mechanism of VSD following hypertrophic obstructive cardiomyopathy operation is different from VSDs after aortic or congenital VSD operations.…”

Section: Discussionmentioning

confidence: 99%

“…Acquired VSDs usually occur after aortic valve replacement surgery, patch opening after VSD repair, trauma or acute myocardial infarction 1 . Post-op VSD after septal myectomy for left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic obstructive cardiomyopathy is a rare complication 2 .…”

Section: Introductionmentioning

confidence: 99%

A successful percutaneous closure of ventricular septal defect following septal myectomy in patients with hypertrophic obstructive cardiomyopathy

et al. 2012

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Postoperative ventricular septal defect (post-op VSD) after septal myectomy in patients with hypertrophic obstructive cardiomyopathy is a rare and unexpected complication. We report a case of successful percutaneous closure of VSD following septal myectomy and mitral valve replacement in a patient with intrinsic mitral valve disease and severe mitral valve regurgitation together with hypertrophic obstructive cardiomyopathy.

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Transcatheter closure of congenital and acquired septal defects

Cited by 11 publications

References 88 publications

Transcatheter closure of ventricular septal defect from retrograde transarterial approach: immediate and long-term outcome

Transcatheter closure of ventricular septal defect from retrograde transarterial approach: immediate and long-term outcome

Transcatheter Atrial Septal Defect Closure in Children with and without Fluoroscopy: A Comparison

A successful percutaneous closure of ventricular septal defect following septal myectomy in patients with hypertrophic obstructive cardiomyopathy

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