Transcatheter Closure of Perimembranous Ventricular Septal Defect Using the Lifetech Konar-Multi Functional Occluder: Early to Midterm Results of the Indonesian Multicenter Study

Kuswiyanto, Rahmat Budi; Gunawijaya, Eka; Djer, Mulyadi M.; Noormanto,; Rahman, Mahrus A.; Murni, Indah K; Sukardi, Rubiana; Utamayasa, Alit; Ardiansyah, Rizky; Nova, Ria; Liliyanti, Sri; Rahayuningsih, Sri Endah; Anggriawan, Shirley L.; Rahayuningsih, Tri Yanti; Koentartiwi, Dyahris; Soewarniaty, Renny; Yantie, Ni Putu Veny Kartika; Nugroho, Sasmito; Hidayat, Taufiq; Ontoseno, Teddy; Tobing, Tina Christina Lumban; Ali, M. Nasr Kaid; Bashari, Muhammad Hasan; Yosy, Deny Salverra; Arafuri, Nadya; Hilmanto, Dany; Yanuarso, Piprim B.; Advani, Najib; Sastroasmoro, Sudigdo; Putra, Sukman Tulus

doi:10.5334/gh.1106

Cited by 11 publications

(14 citation statements)

References 21 publications

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“…Unlike the AMPLATZER Membranous Occluder, the AMPLATZER Duct Occluder II (Abbott Laboratories) and the KONAR-MF multifunctional occluder (Lifetech Scientific) have shown less risk of AVB. 13 , 14 In our subjects, there were no reports of LBBB during follow-up, and 1 patient with complete RBBB at postoperative month 1 converted to normal status at month 6. If AVB or complete LBBB develop during or after procedures, we mandate occluder extraction as soon as feasible, especially in pediatric patients.…”

Section: Discussionmentioning

confidence: 62%

Favorable mid-term performance of fully biodegradable implantable device for ventricular septal defect closure

Song¹,

Shao²,

Fan³

et al. 2023

JTCVS Techniques

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Section: Discussionmentioning

confidence: 62%

Favorable mid-term performance of fully biodegradable implantable device for ventricular septal defect closure

Song¹,

Shao²,

Fan³

et al. 2023

JTCVS Techniques

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“…For all large (>6 mm) defects and cases with SAR < 3 mm, MFO was employed to prevent embolization and the development of insufficiency in the aortic and tricuspid valves. Both devices, with their soft profiles and small delivery sheaths, allow for retrograde or antegrade approaches during implantation ( 21 , 22 ). The ability to be screwed from both sides facilitates the positioning and manipulation of the discs without anatomical constriction on the right side, particularly in pmVSDs with wide and aneurysmal tissue, making the MFO device advantageous compared to ADOII ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg

Yildiz,

Narin,

Oksuz

et al. 2023

Front. Cardiovasc. Med.

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IntroductionDevice closure of perimembranous ventricular septal defects (pmVSD) is a successful off-label treatment alternative. We aim to report and compare the outcomes of pmVSD closure in children weighing less than 10 kg using Amplatzer Duct Occluder II (ADOII) and Konar-MF VSD Occluder (MFO) devices.MethodsRetrospective clinical data review of 52 children with hemodynamically significant pmVSD, and sent for transcatheter closure using ADOII and MFO, between January 2018 and January 2023. Baseline, procedural, and follow-up data were compared according to the implanted deviceResultsADOII devices were implanted in 22 children with a median age of 11 months (IQR, 4.1–14.7) and weight of 7.4 kg (IQR, 2.7–9.7). MFO devices were implanted in 30 children with a median age of 11 months (IQR, 4.8–16.6) and weight of 8 kg (IQR, 4.1–9.6). ADOII were implanted (retrograde, 68.1%) in defects with a median left ventricular diameter of 4.6 mm (IQR, 3.8–5.7) and right ventricular diameter of 3.5 mm (IQR, 3.1–4.9) while MFO were implanted (antegrade, 63.3%) in defects with a median left ventricular diameter of 7 mm (IQR, 5.2–11.3) (p > 0.05) and right ventricular diameter of 5 mm (IQR, 2.0, 3.5–6.2) (p < 0.05). The procedural and fluoroscopy times were shorter with the MFO device (p < 0.05). On a median follow-up of 41.2 months (IQR, 19.7–49.3), valvular insufficiency was not observed. One 13-month-old child (6.3 kg) with ADOII developed a complete atrioventricular heart block (CAVB) six months postoperative and required pacemaker implantation. One 11-month-old child (5.9 kg) with MFO developed a CAVB 3 days postoperative and the device was removed. At 6 months post-procedure, only one child with MFO still experiences a minor residual shunt. There was one arterio-venous fistula that resolved spontaneously.ConclusionBoth the MFO and ADOII are effective closure devices in appropriately selected pmVSDs. CAVB can occur with both devices. The MFO is inherently advantageous for defects larger than 6 mm and subaortic rims smaller than 3 mm. In the literature, our series represents the first study comparing the mid-term outcomes of MFO and ADOII devices in children weighing less than 10 kg.

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“…The su cient distance between the defect and the aortic valve is essential to avoid aortic regurgitation [8,29]. The ideal distance from the defect to the aortic valve using the Lifetech Konar-MF device is more than 2 mm [20,30]. A small number of studies reported that pmVSD without aneurysm is di cult to be treated with the Lifetech Konar-MF device as the symmetrical discs might injure the aortic valve [20].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Ventricular Septal Defect Closure with Lifetech™ Konar-MF Occluder in Infants Under 10 kg with Only Using Venous Access

Ece,

Bağrul,

Kavurt

et al. 2023

Pediatr Cardiol

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Transcatheter closure of VSD remains a complex procedure in infants with technical challenges and carries the risk of signi cant complications, due to its complex anatomical morphology and closed proximity to the atrioventricular valves and the conduction system. In this article, we presented transcatheter VSD closure in infants under ten kilograms using the Lifetech Konar-MF device via only venous route without TEE guidance and arterial access. Between January 2020 and January 2023, a total of 34 patients weighing less than 10 kg who underwent transcatheter VSD closure antegradely with Lifetech Konar-MF device were included in the study. The mean age of the patients was 8.1 (3.5-35) months. Average weight was 6.5kg (range 4.5-10 kg). VSD was perimembranous in 27 patients (79.4%).Successful device placement was achieved in all 34 patients. However, device embolization occurred in three patients. One of the patients was successfully implanted with a one size larger device, the surgical closure was performed other two cases. TR occurred in seven patients (20.6%) after releasing devices.None of the patients developed complete heart block. Right bundle branch block developed in two patients. Residual shunt was observed in 9 patients (six small, two moderate and one large). During follow-up, residual shunt disappeared in six of these patients and only mild residual shunt remained in the other four patients which have not required any further intervention. Transcatheter closure of VSD with Lifetech Konar-MF device is safe and effective in infants less than ten kilograms via only venous access with a high success rate and low complication rate. In these patients, transcatheter VSD closure can be performed by excluding the risk of complications that may occur due to AV loop formation, arterial intervention, endotracheal intubation and TEE use.

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Transcatheter Closure of Perimembranous Ventricular Septal Defect Using the Lifetech Konar-Multi Functional Occluder: Early to Midterm Results of the Indonesian Multicenter Study

Cited by 11 publications

References 21 publications

Favorable mid-term performance of fully biodegradable implantable device for ventricular septal defect closure

Favorable mid-term performance of fully biodegradable implantable device for ventricular septal defect closure

Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg

Transcatheter Ventricular Septal Defect Closure with Lifetech™ Konar-MF Occluder in Infants Under 10 kg with Only Using Venous Access

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