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The AVP II is an effective and safe device for PDA closure. It is particularly useful when dealing with nontypical PDA shapes and in small infants where it eliminated the risk of device-related aortic obstruction. The AVPII is an addition to the PDA device closure armamentarium in pediatric patients.

Objectives: To describe the initial world experience and mid-term follow-up of perimembranous ventricular septal defect (pmVSD) closure with a newly designed occluder. Background: Transcatheter closure of pmVSDs has been associated with a substantial risk of complete heart block, prompting many centers to abandon this intervention. Methods: A prospective multicenter cohort study was conducted on patients with pmVSD undergoing catheter closure using the Amplatzer V R Membranous VSD Occluder 2 in the initial 4 pilot centers. Results: Nineteen patients, median age 6 years (range 1.4-62 years), were enrolled and followed for 14 6 3 months (range 8-20 months). The median weight was 26 kg (range 9.3-96 kg) and the mean Qp/Qs ratio was 1.8 6 0.7. The defect on left ventricular side measured 9.9 6 3.5 mm and the orifice on right ventricular side was 8.1 6 2.8 mm by echocardiography. Mean device size was 9.4 6 2.4 mm (range 5-14 mm). An eccentric device was employed in 9 patients (47%) and a concentric device in 10 (53%). Overall, 18 patients (95%) had successful device implants. Procedural time was 122 6 39 min. There were no procedural complications. Mild residual shunting was initially observed in 14 (78%) patients. At last follow-up, mild residual shunting persisted in only 3 (17%) patients. There was no significant increase in aortic or tricuspid regurgitation. No patient had any degree of AV block, although one developed a transient left anterior fascicular block. Holter evaluation, obtained in all patients, was unremarkable in all. Conclusions: This early cohort experience using a novel adapted transcatheter closure device for pmVSD suggests that the procedure is feasible, safe, and effective. V C 2013 Wiley Periodicals, Inc.

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This initial experience suggests that LAA occlusion with the Amplatzer Amulet device using ICE guidance from the left atrium via a single trans-septal technique is feasible and safe.