Percutaneous closure of congenital Gerbode defect using Nit-Occlud^® Lê VSD coil

Abstract

We present a case report about percutaneous closure of a congenital Gerbode defect using Nit-Occlud® Lê VSD coil. The patient was referred to our hospital with a diagnosis of ventricular septal defect (VSD) and severe pulmonary arterial hypertension. But transthoracic echocardiography revealed a communication between the left ventricle (LV) and the right atrial (RA), called Gerbode defect. Catheterization confirmed the shunt from the LV to the RA. We successfully closed the defect with a VSD coil. After uneventful 6 mo follow-up, the patient was out of dyspnea, the symptom urged him to have medical attention. This case report is to discuss the diagnosis and percutaneous treatment approach for this rare congenital heart disease.

Device Closure of Perimembranous Ventricular Septal Defect: Choosing Between Amplatzer Occluders

“…However, closure rate was only 89.8% at six months of follow-up when compared to higher previous reports (36, 37, 41). In fact, some procedure related complications are reduced with precise defect sizing and proper device selection (42, 43). While oversized devices cause more damage to the adjacent structures, undersized devices may increase the rate of device embolization and RS.…”

Percutaneous closure of perimembranous ventricular septal defect using patent ductus arteriosus occluders

“…Careful defect sizing and proper device selection are also important to reduce the complications of VSD closure [ 25 , 26 ]. While undersized devices increase the rate of device embolization and residual shunt, oversized devices may cause more damage to the adjacent structures and result in complications such as CHB, aortic or tricuspid valvular injury, etc.…”

Recent advances in managing septal defects: ventricular septal defects and atrioventricular septal defects

“…Afterwards, other cardiologists followed his lead and used Rashkind’s double-disc patent ductus arteriosus (PDA) umbrella, Rashkind’s ASD double-umbrella, and clamshell devices for transcatheter occlusion of VSDs 21 – 26 . Subsequently, other devices were used to percutaneously occlude the VSDs: buttoned device (Custom Medical Devices, Amarillo, TX, USA) 27 , 28 , CardioSEAL and STARFlex devices (Nitinol Medical Technologies, Inc., Boston, MA, USA) 29 , Nit-Occlud device (pfm - Produkte für die Medizin AG, Köln, Germany) 30 – 33 , Amplatzer Muscular VSD Occluder device (St. Jude Medical, Inc., St. Paul, MN, USA) 34 – 39 , detachable steel coils (Cook, Bloomington, IN, USA) 40 , Gianturco coils (Cook) 41 , flipper, 0.052ʺ Gianturco, or 0.035ʺ platinum coils (Cook) 42 , wireless devices such as detachable balloon and transcatheter patch (Custom Medical Devices) 43 , Amplatzer Duct Occluder (St. Jude Medical, Inc.) 44 , Shanghai symmetrical perimembranous VSD occluder (Shape Memory Alloy Ltd., Shanghai, China) 45 , Amplatzer Duct Occluder II (St. Jude Medical, Inc.) 46 – 56 , Cera devices (Lifetech Scientific Co. Ltd., Shenzhen, China) 57 , and perhaps other devices (not known to the authors).…”

“…Although CardioSEAL Septal Occlusion System with QwikLoad and the STARFlex Septal Occlusion System have received FDA approval in the past, they are not widely used at present. Free and detachable Gianturco coils 41 , 42 , Nit-Occlud device 30 – 33 , 75 , Amplatzer Duct Occluder 44 , and Amplatzer Duct Occluder II 46 – 56 are also being used on an off-label basis. Discussion of devices used on an off-label basis will not be included in this review; the interested reader may review the respective publications 30 – 33 , 41 , 42 , 44 , 46 – 56 , 75 .…”