Transcatheter coil occlusion of perimembranous ventricular septal defects

Abstract

Transcatheter coil occlusion of a VSD can be performed reliably and safely by selecting appropriate embolic coils. Small defects (<2.5 mm) can be closed with a flipper coil, but defects >or=2.5 mm require a 0.052'' coil.

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 .…”

Multiple transcatheter interventions in the same session in congenital cardiopathies

“…[21–26] Some authors reported ASD and VSD closures as the former procedure of a combined intervention, with an embolization of a PDA or a pulmonary balloon valvuloplasty performed after those procedures. [182728] In our study, coil embolization of ductus in four and coarctation balloon angioplasty in one patient were successfully performed as second procedures of combined interventions after percutanous VSD closure as the first procedure.…”

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

“…[1][2][3] It is categorized according to the location of the principal lesion in the interventricular septum. 5 Surgical closure of VSD has been the treatment of choice in the majority of cases. 4 Subjects with untreated VSD carry a high risk of developing complications such as infective endocarditis, which has a reported incidence of 14.5 per 10 000 patient-years.…”

“…Three main types of VSD are perimembranous, muscular, and supracristal, with perimembranous VSD being the most common type. 5,6 However, postsurgical residual VSD has been reported in 9-36% of all VSDs undergoing surgical repair. 5 Surgical closure of VSD has been the treatment of choice in the majority of cases.…”