Clinical Experience of Transcatheter Closure for Residual Ventricular Septal Defect in Pediatric Patients

Zhou, Wanping; Li, Fen; Fu, Lei; Gao, Wei; Guo, Ying; Liu, Tingliang; Huang, Mei‐Rong; Zhang, Yuqi

doi:10.1111/chd.12357

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…Patients 3 years old and over with hemodynamically significant perimembranous VSD that is adequately separated from the aortic and tricuspid valves are ideal candidates for a transcatheter approach. In cases of a muscular VSD, transcatheter closure is also considered suitable for children weighing ≥5 kg [7]. However, on review of the literature, we did not find any mention of transcatheter closure of postoperative VSDs.…”

Section: Discussionmentioning

confidence: 91%

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The experience of transcatheter closure of postoperative ventricular septal defect after total correction

Kouakou

Song

Huh

et al. 2019

J Cardiothorac Surg

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Background The purpose of this study was to describe our experience with patients who underwent transcatheter closure of a post-operative ventricular septal defect (VSD). Methods All patients who underwent transcatheter closure of a VSD after total correction of congenital heart disease since 2012 were enrolled. Medical records were retrospectively reviewed to determine the patients’ initial diagnosis, closure device used, and final outcome after device closure. Results Six patients with a median age of 17.7 years (range: 7 months–48 years) underwent transcatheter closure of an unresolved VSD. The median time interval from the initial corrective surgery to the percutaneous closure procedure was 10.4 years (range: 0.3–33.0 years). The initial diagnoses included tetralogy of Fallot (one patient), VSD (two patients), double outlet of the right ventricle (two patients), and aortic valve stenosis (one patient). The reasons for unresolved VSD (other than leakage) after corrective surgery included previous fenestration (in two patients), and iatrogenic Gerbode shunt (in one patient). Various devices were used, including the Amplatzer duct occluder I, Amplatzer duct occluder II, Amplatzer vascular plug II, and Cocoon membranous VSD occluder. Only one device was used in each patient. There were no major complications associated with the closure procedures. The immediate results were satisfactory. The median follow-up duration was 2.75 years. All cases were successful, with the exception of minimal leak in one patient. Conclusions Transcatheter device closure of post-operative VSD can be performed using various device types of devices and is safe and effective. But more experiences are mandatory.

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Section: Discussionmentioning

confidence: 91%

“…Most cases of postoperative VSD result from leakage following VSD closure. Most residual defects < 2 mm in size will close spontaneously, while those > 2 mm will not [7, 8]. Volume overload and infective endocarditis are two reasons that a postoperative VSD requires intervention.…”

Section: Discussionmentioning

confidence: 99%

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

Kouakou

Song

Huh

et al. 2019

J Cardiothorac Surg

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“…Solution-processed bulk-heterojunction (BHJ) organic solar cells have drawn extensive interest in the past decade and have been recognized as one of the most promising next-generation green technology alternatives to inorganic photovoltaic cells due to their easy fabrication, light weight, potentially low cost, and mechanical flexibility of organic solar cells. − Also, power conversion efficiencies (PCEs) more than 10% have been achieved for many types of organic solar cells. − To absorb the light of different wavelengths to further improve the PCEs, tandem and ternary solar cells have been intensively studied recently. − Though tandem solar cells can achieve practical PCEs of 14–15%, the device fabrication sacrifices the simplicity of a single active layer processing, which can limit the large-area fabrication of high-performing devices . On the contrary, ternary solar cells comprising two donors and one acceptor or one donor and two acceptors in an active layer are very promising to not only overcome the performance bottleneck of binary solar cells but also keep the advantages of simple device fabrication .…”

Section: Introductionmentioning

confidence: 99%

Ternary Solar Cells Based on Two Small Molecule Donors with Same Conjugated Backbone: The Role of Good Miscibility and Hole Relay Process

Xiao

Liang

Gao

et al. 2017

ACS Appl. Mater. Interfaces

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Ternary organic solar cells (OSCs) are very attractive for further enhancing the power conversion efficiencies (PCEs) of binary ones but still with a single active layer. However, improving the PCEs is still challenging because a ternary cell with one more component is more complicated on phase separation behavior. If the two donors or two acceptors have similar chemical structures, good miscibility can be expected to reduce the try-and-error work. Herein, we report ternary devices based on two small molecule donors with the same backbone but different substituents. Whereas both binary devices show PCEs about 9%, the PCE of the ternary cells is enhanced to 10.17% with improved fill factor and short-circuit current values and external quantum efficiencies almost in the whole absorption wavelength region from 440 to 850 nm. The same backbone enables the donors miscible at molecular level, and the donor with a higher HOMO level plays hole relay process to facilitate the charge transportation in the ternary devices. Since side-chain engineering has been well performed to tune the active materials’ energy levels in OSCs, our results suggest that their ternary systems are promising for further improving the binary cells’ performance although their absorptions are not complementary.

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“…7 Most residual VSDs that are less than 2 mm in size close spontaneously with time and can be followed up. 8 In our series, there was no residual VSD seen on intraoperative transoesophageal echocardiographic analysis, suggesting that they could have been due to postoperative patch dehiscence. The incidence of postoperative patch dehiscence is less than 5%, but not much data is available.…”

Section: Discussionmentioning

confidence: 48%

Transcatheter Device Closure of Postsurgical Residual Left to Right Shunt Lesions in Children during the Immediate Postoperative Period

Kidwai,

Abqari,

Kamran

et al. 2023

Indian Journal of Clinical Cardiology

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Objectives Postoperative residual shunts in the form of ventricular septal defects (VSD) and patent ductus arteriosus (PDA), if hemodynamically significant, can lead to symptoms of left ventricular volume overload and delayed recovery. The standard management is redo surgery, which can lead to significant morbidity and mortality. Device closure of such defects offers an alternative management strategy in selected cases. This study aims to examine the utility of device closure of residual left-to-right shunts in the pediatric age group in the immediate postoperative period. Method A retrospective analysis of hospital records was done from March 2018 to December 2022 to analyze the device closure in postoperative residual shunts. The success rate, complications, hospital length of stay, and midterm follow-up were analyzed. Results A total of four postoperative patients underwent VSD device closure and one patient underwent PDA device closure. The median age at transcatheter procedure was 6 years (range 3–10 years). The median time interval between the surgical procedure and the device closure procedure was 4 days (range 2–15 days). The indication for device closure was left ventricular volume overload in three patients and two patients had persistent pleural effusion. Qp:Qs was more than 1.5:1 in all five patients. The amplatzer duct occluder I (ADO-I) device was used in four patients and the ADO-II in one patient. There was no residual shunt post-deployment, with no major complication. The mean follow-up period was 2 years and all the patients had no residual shunt. Conclusion This case series, with its limitation of only five cases, has shown that device closure of hemodynamically significant residual postoperative left-to-right shunt lesions is an effective alternative strategy to redo surgery in older children. Further study is required with a larger sample size, and a longer follow-up is needed to evaluate its long-term safety and efficacy.

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Clinical Experience of Transcatheter Closure for Residual Ventricular Septal Defect in Pediatric Patients

Abstract: More robust studies with longer-term follow-up of outcomes are required to firmly establish the safety profile and respective indications for use of various occluder devices for treating different categories of residual VSD.

Cited by 13 publications

References 24 publications

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

Ternary Solar Cells Based on Two Small Molecule Donors with Same Conjugated Backbone: The Role of Good Miscibility and Hole Relay Process

Transcatheter Device Closure of Postsurgical Residual Left to Right Shunt Lesions in Children during the Immediate Postoperative Period

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