Transcatheter VSD Closure

Kenny, Damien; Cao, Qi; Hijazi, Ziyad M.

doi:10.1002/9781118504499.ch30

Cited by 1 publication

(2 citation statements)

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“…The AVP II has been considered even in cases without aortic rim. 7,23 Lastly, TEE is the imaging modality most frequently used for device closure. But most of our patients were smaller children with less than 10 kg where TEE use is difficult and sometimes time-consuming.…”

Section: Technical Challenges In Transcatheter Device Closure Of Pmvsmentioning

confidence: 99%

“…6 Since then a number of studies involving transcatheter techniques of VSD closure have reported encouraging results with acceptable mortality and morbidity. 7,8 Surgical closure is still the recommended approach especially for large perimembranous defects. Advancements in device designs and operator experience have led to increased utilization of transcatheter techniques in patients with pmVSD.…”

Section: Introductionmentioning

confidence: 99%

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Transcatheter Closure of Moderate to Large Perimembranous Ventricular Septal Defects in Children Weighing 10 kilograms or less

Pillai

Rangasamy

Balasubramonian

2019

World J Pediatr Congenit Heart Surg

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Background: Transcatheter device closure of ventricular septal defect (VSD) is an alternative to conventional surgical closure. Device closure of moderate to large perimembranous VSD (pmVSD) is considered technically challenging in smaller children weighing 10 kg. Very few studies are published on the outcomes of the same. Methods: Descriptive single-center retrospective study. Data of 49 children 10 kg with moderate to large pmVSDs taken up for transcatheter device closure in our institute were analyzed and their follow-up details were reviewed. Results: Of the 87 patients referred for VSD closure, 49 patients qualified for the inclusion criteria. Median age was 18 months (interquartile range: 13-22). Successful device deployment was achieved in 42 (85.7%) patients. Mean VSD size by transthoracic echocardiography was 5.98 mm (range: 4-12 mm). Mean waist size of the device used was 8.26 mm (range: 4-14 mm). There was one device embolization, requiring catheter-directed retrieval from the left ventricle and subsequent surgical referral for VSD closure. Minor complications such as device-related persistent new aortic regurgitation was noted in one patient and mild tricuspid regurgitation and transient heart block occurred in two patients each. There was no mortality or complete heart block requiring permanent pacemaker implantation immediately or during midterm follow-up (mean follow-up: 20 months; range: 6-72.5 months). Conclusion: Device closure of moderate to large pmVSDs in children weighing 10 kg is feasible and safe with a success rate of 85.7%. Careful selection of patients and avoidance of oversizing the defect makes the immediate and midterm results acceptable. Keywords moderate to large perimembranous VSD (pmVSD), transcatheter device closure, success rate, complete heart block (CHB), aortic regurgitation (AR), children 10 kg

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Section: Technical Challenges In Transcatheter Device Closure Of Pmvsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%