Complete heart block following transcatheter closure of perimembranous VSD using amplatzer duct occluder II

Ghosh, Siddhartha; Sridhar, Anuradha; Sivaprakasam, Muthukumaran C.

doi:10.1002/ccd.27177

Cited by 26 publications

(17 citation statements)

References 8 publications

(16 reference statements)

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“…This finding corresponds to those described in the post-admission trial EUROVECO-Registry [11] and stands in contrast to the Amplatzer registry with an AV block rate of 5.7% [2][3][4]. Even with the so-called second-generation devices, AV block could not be completely eliminated [10,20]. Recently, it was shown that with new devices, the longterm complication rate is low, however, eccentric, large devices, and long fluoroscopy time increase the risk of early postprocedural arrhythmias after transcatheter closure of VSDs up to 24.1% [29].…”

Section: Discussionsupporting

confidence: 85%

Long-term outcome of perimembranous VSD closure using the Nit-Occlud® Lê VSD coil system

et al. 2020

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Objective This study presents data from the admission trial to show the feasibility, safety and effectiveness of the Nit-Occlud® Lê VSD in the treatment of perimembranous ventricular septal defects with an aneurysmal configuration and a diameter up to 8 mm. Background The majority of ventricular septal defects (VSD) are still closed surgically, while a less invasive transcatheter treatment by closure devices is available. Device-based closure is reported to be associated with the risk of complete atrio-ventricular block, especially with double-disc devices in perimembranous defects. Methods In six tertiary centers in Germany and Israel, an interventional closure of a periembranous VSD was attempted in 88 patients using the Nit-Occlud® Lê VSD. Results The interventional VSD closure was performed in 85 patients. Patients had a median age of 8.0 (2–65) years and a median body weight of 26.7 (10–109) kg. A complete closure of the defects was achieved in 85.4% 2 weeks after device implantation, in 88.9% after three months and in 98.6% at the 5-year follow-up. There was no incidence of death during the study nor did any patient suffer of permanent atrio-ventricular block of higher degree. Serious adverse events, by definition, are potentially life-threatening or require surgery to correct, while major serious events require medical or transcatheter intervention to correct. The study results exhibit a serious adverse event rate of 3.5% (3/85 patients) and a major adverse event rate of 5.9% (5/85 patients). Conclusion The Nit-Occlud® Lê VSD coil offers the possibility of an effective and safe approach in patients with aneurysmal perimembranous ventricular septal defects.

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Section: Discussionsupporting

confidence: 85%

Long-term outcome of perimembranous VSD closure using the Nit-Occlud® Lê VSD coil system

et al. 2020

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“…12,13 Due to the more flexible and finer meshwork of the ADO II device, the devices can advance through small 4F of 5F catheter systems, which from the technical point of view allow theoretically VSD closure even in young infants or newborns. 14 We report our follow-up results of percutaneous closure of perimembranous VSDs in different ages and locations with ADO II supporting the requirement of larger sizes of ADO II devices. 12 Until today only one single case with a late onset of cAVB is described.…”

Section: Introductionmentioning

confidence: 62%

Percutaneous closure of perimembranous ventricular septal defects utilizing almost ideal Amplatzer Duct Occluder II: Why limitation in sizes?

Esmaeili

Behnke-Hall

Schrewe

et al. 2018

Congenital Heart Disease

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Aim:The purpose of this study is to describe the special aspects of perimembranous ventricular septal defects (pmVSD) closure by utilizing Amplatzer Duct Occluder II (ADO II) devices with a rational request for bigger ADO-II sizes, based on our experience in transcatheter device closure of pmVSD. Methods and Results: At our institution, placement of an ADO II device was used in 15 patients with pmVSD; the patients' age ranged between 6 months and 20 years.The indications for closure were CHF (n = 4), hemodynamically significant shunt (n = 7), tricuspid regurgitation (n = 3), and high risk for infective endocarditis (n = 2), respectively. The location of the VSD was infracristal in 13 patients, supracristal in 1, and a postsurgical Gerbode VSD in another one. Implantation of the device was successfully performed without embolization, any evidence of an AV block, or other conductance abnormalities during implantation and follow-up in the mean of 2.5 years (range 2 months-6.5 years). Conclusions: Transcatheter closure of a pmVSD with ADO II is feasible in all pediatricand young adult age groups, by considering the device diameter limitations. The offlabel use of ADO II implantation seems to be safe for VSDs closure up to 6 mm of size and feasible for various locations including unusual morphology such as postsurgical Gerbode defect. K E Y W O R D SAmplatzer Duct Occluder II, pediatric, perimembranous ventricular septal defect, transcatheter closure

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“… 8) 9) 10) As a result, there are important modifications for the prevention of CAVB, and various positive clinical experiences have since been reported with those devices. 11) 12) In Korea, there was a report about transcatheter closure of perimembranous VSD with an Amplatzer duct occluder I, 1) but it was an off-label use of the device. Recently, various types of Cocoon occluders (Vascular Innovations Co., Nonthaburi, Thailand) for VSD were developed.…”

Section: Introductionmentioning

confidence: 99%

Early Experiences Using Cocoon Occluders for Closure of a Ventricular Septal Defect

Park

Song

Kim

et al. 2018

J Cardiovasc Imaging

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BACKGROUNDTranscatheter device closure of ventricular septal defect (VSD) has become an attractive alternative to surgery. We report here on our early experiences of transcatheter closure of VSD using Cocoon devices, which are now available in Korea.METHODSWe reviewed the medical records and angiographic images of 13 patients who underwent transcatheter closure of VSD with a Cocoon occluder at Samsung Medical Center. The median patient age was 5.8 years, and the median patient weight was 20.3 kg.RESULTSThe device was successfully implanted in all patients. The follow-up period was 10 ± 6 months, and no mortality was observed. An immediate residual leak on the next day was detected in 7 patients (including 4 with perimembranous VSD). However, 6 months later, a residual leak was observed only in 2 patients with perimembranous VSD and 1 patient with muscular VSD. Early conduction abnormalities were observed in 3 patients, all of whom had perimembranous VSD, but no significant complete atrioventricular block was observed. One patient experienced newly developed significant aortic regurgitation that decreased spontaneously but still existed at the 6 month follow-up. No hemolysis or embolization was noted on the next day or during the follow-up period.CONCLUSIONSCocoon devices can be used safely and effectively for VSD closure. However, residual leaks and conduction abnormalities may occur early after implantation, especially in patients with perimembranous VSD. Although normal conduction was recovered, long-term evaluation remains essential.

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Complete heart block following transcatheter closure of perimembranous VSD using amplatzer duct occluder II

Cited by 26 publications

References 8 publications

Long-term outcome of perimembranous VSD closure using the Nit-Occlud® Lê VSD coil system

Long-term outcome of perimembranous VSD closure using the Nit-Occlud® Lê VSD coil system

Percutaneous closure of perimembranous ventricular septal defects utilizing almost ideal Amplatzer Duct Occluder II: Why limitation in sizes?

Early Experiences Using Cocoon Occluders for Closure of a Ventricular Septal Defect

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