Infective endocarditis following coil occlusion of perimembranous ventricular septal defect with the Nit-Occlud <sup>(®)</sup> Le device

El-Sisi, Amal; Menaissy, Yasser; Bekheet, Samia B.

doi:10.4103/0974-2069.171355

Cited by 15 publications

(13 citation statements)

References 9 publications

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“…Even though native VSD endocarditis is well known, [9] device-associated endocarditis following PmVSD closure is scarce. Up to now, only 2 cases with post procedure IE occurred 10 days [7] and 4 months [6] after transcatheter closure of PmVSD with Nit-Occlud Le device, respectively, have been reported. To our knowledge, this is the first case of IE complicated by residual shunt after percutaneous PmVSD occlusion using modified symmetric double-disk occluder.…”

Section: Discussionmentioning

confidence: 99%

“…[5] Post-procedure IE after transcatheter closure of PmVSD is rarely reported. [6,7] Herein, we first described a case of IE after transcatheter closure of PmVSD with modified symmetrical double-disk device with a residual shunt, highlighting the need for reassessing the prognostic implications of post procedure non-significant residual shunt and the most appropriate treatment strategy.…”

Section: Introductionmentioning

confidence: 99%

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What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect

et al. 2019

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Rationale:Non-significant residual shunt is a relatively common complication after device closure of perimembranous ventricular septal defects (Pm-VSD). Lifelong antibiotic prophylaxis has been recommended in guidelines to avoid infectious endocarditis (IE) if residual shunt remains. Clinicians, however, rarely follow it in their practice and regular follow-up was the most common option since post-procedure IE after transcatheter closure of PmVSD is rarely reported. We firstly described a case of IE after transcatheter closure of PmVSD with modified symmetrical double-disk device with a residual shunt, highlighting the need for reassessing the prognostic implications of post-procedure non-significant residual shunt and the most appropriate treatment strategy.Patient concerns:A 3-year old female received transcatheter closure of PmVSD sized 5.0 mm on left ventricular angiography with an 8-mm modified symmetric double-disk occluder (SHAMA) owing to a history of recurrent lower respiratory tract infections. Post-procedure echocardiography documented a non-significant residual shunt, but no additional interventions were performed. Two months post procedure, the child was re-admitted into our department with a complaint of persistent fever up to 41°C for 11 days and nonresponse to 1-week course of amoxicillin.Diagnoses:The diagnosis of post procedure IE was established since a vegetation (13 × 9 mm) was found to be attached to the tricuspid valve and the occluder, and Staphylococcus aureus was isolated from all three-blood cultures.Interventions:After 6 weeks of vancomycin treatment, the vegetation disappeared with no sign of valvular dysfunction. Three weeks after discharge, a second device was implanted to abolish persistent residual flow.Outcomes:Unfortunately, the child was ultimately transferred to surgical department due to severe hemolysis after the second device implantation. The occluders were removed and the VSD was closed with a pericardial patch. Tricuspid valvuloplasty was also performed and the following course was uneventful.Lessons:For non-significant residual shunt after device closure of PmVSD, implantation of a second device or surgical repair may be a better and more satisfactory alternative compared with lifelong antibiotic prophylaxis or no interventions, since associated IE can indeed occur despite its rarity and the risk of antibiotic-associated adverse events may outweigh the benefits.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect

et al. 2019

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“…[14151617] A study of 125 patients with isolated VSD who were followed up for a mean of 15 years showed no statistical difference in the incidence of bacterial endocarditis between the untreated patients (4.3%) and those that were surgically closed (2.7%) although the sample size of the study was small. [18] The Swedish registry data also showed an incidence of endocarditis of 1.2% in patients who had undergone surgery for VSD versus an overall incidence of 2% in the entire group.…”

Section: What Is the Incidence Of Infective Endocarditis In Patients mentioning

confidence: 99%

Should we close small ventricular septal defects?

Sangeetha

Kumar

2017

Annals of Pediatric Cardiology

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“…Ventricular septal defect (VSD) is one of the most common types of congenital cardiac disease (CHD) in children especially perimembranous variant [2]. Surgical closure of VSD carries a low risk of morbidity and mortality, however transcatheter closure is less invasive, has a faster recovery and requires less hospital stay period [3]. Transcatheter VSD closure has been developed in order to reduce surgical complications [4].…”

Section: Introductionmentioning

confidence: 99%

Aortic Valve Endocarditis Post Ventricular Septal Defect Device Closure: Case Report

Mubarak¹

2022

JCRR

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Ventricular septal defect (VSD) is a common congenital heart disease (CHD) in childhood, and its incidence is about 20% of CHD. Surgical closure or repair is safe with acceptable results. Transcatheter VSD closure offers excellent results. Coil system is developed for transcatheter VSD occlusion. Infective endocarditis (IE) post device implantation is very rare; however, it is possible. IE represents a surgical challenge associated with perioperative mortality

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Infective endocarditis following coil occlusion of perimembranous ventricular septal defect with the Nit-Occlud ^(®) Le device

Cited by 15 publications

References 9 publications

What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect

What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect

Should we close small ventricular septal defects?

Aortic Valve Endocarditis Post Ventricular Septal Defect Device Closure: Case Report

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Infective endocarditis following coil occlusion of perimembranous ventricular septal defect with the Nit-Occlud (®) Le device

Cited by 15 publications

References 9 publications

What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect

What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect

Should we close small ventricular septal defects?

Aortic Valve Endocarditis Post Ventricular Septal Defect Device Closure: Case Report

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Product

Resources

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Infective endocarditis following coil occlusion of perimembranous ventricular septal defect with the Nit-Occlud ^(®) Le device