Evaluation of a new hybrid technique for closure of muscular ventricular septal defects in a long-term setting

Kozlik‐Feldmann, Rainer; Lang, Nora; Lehner, Anja; Sigler, Matthias; Schmitz, Christoph; Sodian, Ralf; Freudenthal, Franz; Dalla‐Pozza, Robert; Vasilyev, N. V.; Nido, Pedro J. del; Netz, Heinrich

doi:10.1016/j.jtcvs.2009.02.014

Cited by 6 publications

(4 citation statements)

References 29 publications

(51 reference statements)

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“…Thus, VSD models prepared by surgical methods have been widely used; previous research reported that the success rate of modeling was 80-85%, and the short-term (2 weeks to 3 months) survival rate of experimental animals after successful modeling was 86-91%, showing good results. [7][8][9] In our study, the success rate was 87.5% (14 of 16), and the survival rate of experimental canines at 4 weeks postoperatively was 93% (13 of 14), comparable to surgical modeling. The success rate of modeling is not only related to the skill of the surgeon, but also to the trauma and experimental conditions, as surgical modeling requires opening of the thorax and pericardium, which thus increases the risk of infection and hemodynamic disorders, and is a test of the animal's tolerance.…”

Section: Discussionsupporting

confidence: 72%

The Application and Teaching Value of a Ventricular Septal Defect Canine Model Established by Transcatheter Puncture

et al. 2021

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This study aimed to improve and further explore a ventricular septal defect (VSD) canine model on the basis of the transcatheter puncture method and to evaluate its application and teaching value. In order to lessen the complications of VSD closure, it is necessary to improve the currently available treatment devices using appropriate animal models. In this study, we used 16 healthy adult canines as our models. After anesthesia, the VSD puncture was performed, followed by balloon dilatation of the perforation. VSD was confirmed by angiography. The venousartery orbit was established, and the VSD was then closed once the catheter and occluder were across the defect. Of the experimental canines, 14 of the 16 canines were successfully modeled, giving a success rate of 87.5%. The canines underwent an immediate creation of a venous-artery orbit for teaching practice and were implanted with an occluder during the procedure. After 4 weeks, 13 canines survived. As per our findings, most VSD types established by the puncture were perimembranous (10 of 13, 77%). The current model has a high success rate. The model can not only avoid the risk of infection and hemodynamic disorders associated with an open thoracotomy, but can also be effectively used in evaluating the impact of occluders. It can also directly measure the parameters of the devices during the procedure, thus having a very high experimental and teaching value.

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Section: Discussionsupporting

confidence: 72%

The Application and Teaching Value of a Ventricular Septal Defect Canine Model Established by Transcatheter Puncture

et al. 2021

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“…However, CPB can lead to a series of complications, and the indications of interventional therapy are relatively strict. The application of both is greatly limited [14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Exploration to the Application of Hybird Technology in Special Types of Congenital Heart Diseases in Children

Liu¹,

Wang²,

Wen³

2020

Preprint

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Background Hybrid technology has become a hot topic in cardiovascular surgery,has been widely used in the minimally invasive closure of simple coronary heart diseases (CHDs). For some children with special CHDs, it is still impossible to avoid the huge trauma caused by cardiopulmonary bypass. This study aimed to investigate the feasibility、safety and efficacy of hybrid technology in the treatment of several specific CHDs. Methods A total of 29 children with specific CHDs hospitalised in the Cardiac Surgery Department of Dalian Children’s Hospital from July 2014 to June 2019 were enrolled. There were 2 cases of right coronary artery-right ventricular fistula, 17 cases of neonatal critical pulmonary stenosis (CPS), 9 cases of neonatal pulmonary atresia-intact ventricular septum (PA/IVS), and 1 case of giant aortopulmonary window (APW). All of them underwent surgical treatment with hybrid technology guided by transoesophageal echocardiography (TEE). The TEE enabled immediate evaluation of the surgical curative effect. Further chest X-ray, electrocardiogram (ECG) and echocardiogram were performed in the outpatient department after discharge. Results The surgical treatment with hybrid technology was smooth except that 1 CPS patient was converted to open-heart surgery with cardiopulmonary bypass (CPB) due to a torn right ventricular outflow tract after balloon dilatation. No complication, such as wound or intracardiac infection, arrhythmia or pericardial effusion occurred. No children have been lost to follow-up and the investigation results and prognosis remain satisfactory. Conclusions the use of hybrid technology is a safe and effective alternative therapy for specific paediatric CHD cases. It has significant advantages in alleviating trauma and reducing medical costs and, therefore, has good prospects for broad application in the future.

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“…The device consists of Nitinol and polyester. Long‐term studies regarding these materials have been done before [23, 27–31]. These investigations showed a good integration of the devices into the muscular septum and complete neoendotheliazation after three to six months indicating good biocompatibility.…”

Section: Discussionmentioning

confidence: 99%

“…Swelling of the surrounding tissue occurs immediately after creation which results in underestimation of the defect by echocardiography. Moreover, a zone of necrosis can be detected around the artificial created VSDs [28], which is different to natural occurring VSDs.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Preclinical evaluation of a new self‐expanding device for closure of muscular ventricular septal defects in a pig model

Lang

Schmitz

Lehner

et al. 2009

Cathet Cardio Intervent

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Evaluation of a new hybrid technique for closure of muscular ventricular septal defects in a long-term setting

Abstract: Our hybrid therapy was efficacious in closing muscular ventricular septal defects without impairment of cardiac function. The patch system and nitinol anchors demonstrated good integration into the septum. Further development of the system for human application is already being undertaken.

Cited by 6 publications

References 29 publications

The Application and Teaching Value of a Ventricular Septal Defect Canine Model Established by Transcatheter Puncture

The Application and Teaching Value of a Ventricular Septal Defect Canine Model Established by Transcatheter Puncture

Exploration to the Application of Hybird Technology in Special Types of Congenital Heart Diseases in Children

Preclinical evaluation of a new self‐expanding device for closure of muscular ventricular septal defects in a pig model

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