A Comparative Study of Perventricular and Percutaneous Device Closure Treatments for Isolated Ventricular Septal Defect: A Chinese Single-Institution Experience

Huang, Xiaobi; Luo, Zeng-Rong; Chen, Qiang; Yu, Ling-Shan; Cao, Hua; Zhang, Gui-Can

doi:10.21470/1678-9741-2018-0351

Cited by 9 publications

(5 citation statements)

References 23 publications

(23 reference statements)

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“…Although few patients had transitory rhythm disturbances during the study, some of them returned with complete AV block and had a pacemaker implanted permanently. Some authors have mentioned that, in case of early complete AV block due to mechanical injury during manipulation of the delivery system or during device implant, conversion to open surgery should be considered [ 7 , 10 ]. The cause of late-onset complete AV block remains unknown, but it probably occurs as a result of chronic inflammation and fibrosis due to the device, which is more likely to occur in infants with large defects.…”

Section: Discussionmentioning

confidence: 99%

Single-stage off-pump repair of coarctation of the aorta and ventricular septal defects in children

Kulyabin

Voitov

Nichay

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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Objectives The appropriate approach for surgical repair of coarctation of the aorta with ventricular septal defect remains controversial. This study evaluated the outcomes of primary repair of ventricular septal defects with perventricular device closure without cardiopulmonary bypass through left thoracotomy in patients without arch hypoplasia. Methods We selected 21 patients aged <1 year, including 7 neonates, who underwent repair of coarctation of the aorta with perventricular device closure of ventricular septal defect. Results The median occluder size was 6 (range, 5–8) mm. The median mechanical ventilation time was 14 (range, 2–68) h, and the median duration of hospital stay was 11 (range, 7–16) days. No reoperations were required to correct ventricular septal defect shunting, and the median residual shunt size was 1 (range, 1–2) mm. The median follow-up period was 13 (range, 4–31) months. No late mortality was reported, and no haemodynamically significant pressure gradient at the anastomotic site was observed. The median distal aortic arch z-score was 0.39 (range, −0.1 to 0.9). Only one patient underwent permanent pacemaker implantation towards the end of the follow-up. Conclusions PVDC can be used safely for closure of VSD in children with CoAo without a hypoplastic aortic arch even in neonates to reduce the risk of prolonged CPB. This hybrid approach can be performed with low incidence of rhythm disturbances and residual shunting. However, a meticulous assessment of the VSD anatomy is essential to avoid any unfavorable events.

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Section: Discussionmentioning

confidence: 99%

Single-stage off-pump repair of coarctation of the aorta and ventricular septal defects in children

Kulyabin

Voitov

Nichay

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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“…The procedure has been shown to be safe and feasible in the setting of AR. In a recent review for the safety of device closure for VSD, it was found that percutaneous and perventricular device closure for VSD are safe and did not have any extra morbidity [ 15 ] .…”

Section: Discussionmentioning

confidence: 99%

Syndrome of Ventricular Septal Defect and Aortic Regurgitation — A 22-Year Review of its Management

Krishnasamy¹,

Sivalingam²,

Dillon³

et al. 2021

Braz J Cardiovasc Surg

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Introduction The presence of aortic regurgitation (AR) in the setting of ventricular septal defect (VSD) has always been a management challenge. Methods This is a retrospective study looking at patients who underwent VSD closure with or without aortic valve intervention between January 1st, 1992 and December 31st, 2014 at the Institute Jantung Negara. This study looked at all cases of VSD and AR, where AR was classified as mild, moderate, and severe, the intervention done in each of this grade, and the durability of that intervention. The interventions were classified as no intervention (NI), aortic valve repair (AVr), and aortic valve replacement (AVR). Results A total of 261 patients were recruited into this study. Based on the various grades of AR, 105 patients had intervention to their aortic valve during VSD closure. The rest 156 had NI. All patients were followed up for a mean time of 13.9±3.5 years. Overall freedom from reoperation at 15 years was 82.6% for AVr. Various factors were investigated to decide on intervening on the aortic valve during VSD closure. Among those that were statistically significant were the grade of AR, size of VSD, age at intervention, and number of cusp prolapse. Conclusion We can conclude from our study that all moderate and severe AR with small VSD in older patients with more than one cusp prolapse will need intervention to their aortic valve during the closure of VSD.

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“…Comparing transthoracic and transcatheter device closure of VSD, the transthoracic procedure provides a shorter path and a more perpendicular angle to the defect. [23] During both procedures of device closure, the most important step is to guide the wire through the VSD to establish the delivery track. Based on our experience with color Doppler imaging by TEE, the wire was easy to aim toward and through the VSD during the transthoracic procedure.…”

Section: Discussionmentioning

confidence: 99%

Transthoracic closure of ventricular septal defects guided by transesophageal echocardiography

Huang

Kim

et al. 2020

Turk Gogus Kalp Dama

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Bu çalışmada tamamen transözofageal ekokardiyografi eşliğinde ventriküler septal defektlerin transtorasik olarak kapatılmasının etkinliği ve güvenliliği değerlendirildi. Ça lış ma pla nı: Nisan 2017-Kasım 2018 tarihleri arasında merkezimizde ventriküler septal defektlerin transtorasik olarak kapatıldığı toplam 119 hasta (62 erkek, 57 kadın; ort. yaş 2.1±5.2 yıl; dağılım, 11 ay-50 yıl) çalışmaya alındı. Hastaların tümü ventriküler septal defektlerin çapı ve morfolojik özellikleri açısından transtorasik ekokardiyografi ile değerlendirildi. İşlem sırasında transtorasik ekokardiyografi oklüder yerleştirilmesi için kullanılan tek kılavuz araç idi. Bul gu lar: Hastaların 116'sında transtorasik cihaz kapama işlemi başarılı idi. Bir hastada yeni başlangıçlı aort yetmezliği ve bir diğer hastada cihaz yerleştirildikten sonra şiddetli aritmiler nedeniyle olmak üzere, iki hastada cerrahi onarıma geçildi. Bir hastaya hastane yatışı sırasında oklüder migrasyonu nedeniyle ikinci bir ameliyat yapıldı. İlk girişimde 106 ventriküler septal defekt oklüderi doğru bir şekilde yerleştirildi. On hastada transtorasik ekokardiyografide güvenli olmayan yerleşim veya önemli düzeyde rezidüel şant izlendi. İlk takılan cihaz asimetrik cihaz veya daha kapsamlı bir oklüder ile değiştirildi ve nihayetinde memnun edici sonuçlar alındı. Takip sırasında yeni başlangıçlı aort yetmezliği, rezidüel şant, tam kalp bloku veya cihazın yerinden çıkması gibi komplikasyonlar gözlenmedi. So nuç: Ventriküler septal defektlerin tamamen transtorasik ekokardiyografi eşliğinde transtorasik olarak kapatılması güvenli ve etkili bir yöntemdir.

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A Comparative Study of Perventricular and Percutaneous Device Closure Treatments for Isolated Ventricular Septal Defect: A Chinese Single-Institution Experience

Cited by 9 publications

References 23 publications

Single-stage off-pump repair of coarctation of the aorta and ventricular septal defects in children

Single-stage off-pump repair of coarctation of the aorta and ventricular septal defects in children

Syndrome of Ventricular Septal Defect and Aortic Regurgitation — A 22-Year Review of its Management

Transthoracic closure of ventricular septal defects guided by transesophageal echocardiography

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