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Closure of perimembranous ventricular septal defects using the Amplatzer vascular plug II: experience of a Mexican centre

Published online by Cambridge University Press:  24 February 2025

Roberto Mijangos-Vázquez*
Affiliation:
Pediatric Interventional Cardiology Department, Pediatric Specialties Hospital, Tuxtla Gutiérrez Chiapas, México
Rogelio Hernández-Reyes
Affiliation:
Pediatric Interventional Cardiology Department, Pediatric Specialties Hospital, Tuxtla Gutiérrez Chiapas, México
*
Corresponding author: Roberto Mijangos-Vázquez; Email: dr.rmijangos@gmail.com

Abstract

Objectives:

To demonstrate safety and efficacy of using the AmplatzerTM vascular plug II device for perimembranous ventricular septal defect closure with retrograde approach and show the follow-up in all patients.

Background:

At present, there is no FDA-approved device for transcatheter closure of perimembranous ventricular septal defects. Small studies and case reports have shown the use of various catheter-based devices in an off-label management; however, there are no large studies to show their efficacy. The second generation of AmplatzerTM vascular plug seems to offer a safe and attractive alternative for this procedure. Besides, a retrograde approach might decrease procedure time and radiation exposure time.

Methods and Results:

Patients with congenital perimembranous ventricular septal defects who underwent transcatheter closure using Amplatzer vascular plug II devices were included. Primary end point was to determine efficacy and safety of this generation of devices and the incidence of complications at follow-up (complete heart block and aortic/tricuspid/mitral regurgitation). Forty-five patients underwent perimembranous ventricular septal defect closure at a median age of 6 years (9 months–17 years). During the catheterization, there were only minor complications and at follow-up of 48 ± 25.7 months (up to 96 months). Closure rate was high of 93.3% and freedom from atrioventricular block was 100%.

Conclusions:

The second generation of the AmplatzerTM vascular plug II seems to offer a safe and attractive alternative for percutaneous closure of the perimembranous ventricular septal defects.

Type
Original Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Mavroudis, C, Backer, CL, Jacobs, JP. Ventricular septal defect. 3rd edn. Pediatric Cardiac Surgery, Mosby, Philadelphia, 2003, 298320.Google Scholar
Yilmaz, AT, Ozal, E, Arslan, M, Tatar, H, Ozturk, OY. Aneurysm of the membranous septum in adult patients with perimembranous ventricular septal defect. Eur J Cardiothorac Surg 1997; 11: 307311.CrossRefGoogle ScholarPubMed
Moe, DG, Guntheroth, WG. Spontaneous closure of uncomplicated ventricular septal defect. Am J Cardiol 1987; 60: 674678.CrossRefGoogle ScholarPubMed
Bol-Raap, G, Weerheim, J, Kappetein, AP, Witsenburg, M, Bogers, AJ. Follow-up after surgical closure of congenital ventricular septal defect. The European Journal of Cardio-Thoracic Surgery 2003; 24: 511515.CrossRefGoogle ScholarPubMed
Arora, R, Trehan, V, Kumar, A, Kalra, GS, Nigam, M. Transcatheter closure of congenital ventricular septal defects: experience with various devices. J Interv Cardiol 2003; 16: 8391.CrossRefGoogle ScholarPubMed
Tuite, DJ, Kessel, DO, Nicholson, AA, Patel, JV, McPherson, SJ, Shaw, DR. Initial clinical experience using the amplatzer vascular plug. Cardiovasc Intervent Radiol 2007; 30: 650654.CrossRefGoogle ScholarPubMed
Ramaciotti, C, Keren, A, Silverman, NH. Importance of (perimembranous) ventricular septal aneurysms in the natural history of isolated perimembranous ventricular septal defect. Am J Cardiol 1986; 57: 268272.CrossRefGoogle ScholarPubMed
Pedra, CA, Pedra, SR, Esteves, CA et al. Percutaneous closure of perimembranous ventricular septal defects with the amplatzer device: technical and morphological considerations. Catheter Cardiovasc Interv 2004; 3: 403410.CrossRefGoogle Scholar
El Said, H, Bratincsak, A, Gordon, BM, Moore, JW. Closure of perimembranous ventricular septal defects with aneurysmal tissue using the amplatzer duct occluder I: lessons learned and medium term follow up. Catheter Cardiovasc Interv 2012; 80: 895903.CrossRefGoogle ScholarPubMed
Hijazi, ZM, Hakim, F, Al-Fadley, F, Abdelhamid, J, Cao, QL. Transcatheter closure of single muscular ventricular septal defects using the amplatzer muscular VSD occlude: initial results and technical considerations. Catheter Cardiovasc Interv 2000; 49: 167172.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Szkutnik, M, Kusa, J, Bialkowski, J. Percutaneous closure of perimembranous ventricular septal defects with amplatzer occluders—a single-center experience. Kardiol Pol 2008; 66: 941947.Google Scholar
Holzer, R, Balzer, D, Lock Qi-Ling Cao, K, Hijazi, ZM. Device closure of muscular ventricular septal defects using the amplatzer muscular ventricular septal defect occluder. Immediate and mid-term results of a US registry. J Am Coll Cardiol 2004; 43: 12571263.CrossRefGoogle ScholarPubMed
Anderson, RH, Becker, AE, Tynan, M. Description of ventricular septal defects—Or how long is a piece of string? Int J Cardiol 1986; 13: 267278.CrossRefGoogle Scholar
Carminati, M, Butera, G, Chessa, M, Drago, M, Negura, D, Piazza, L. Transcatheter closure of congenital ventricular septal defect with amplatzer septal occluders. Am J Cardiol 2005; 96: 52L58L.CrossRefGoogle ScholarPubMed
Ebeid, MR, Batlivala, SP, Salazar, JD et al. Percutaneous closure of perimembranous ventricular septal defects using the second-generation amplatzer vascular occluders. Am J Cardiol 2016; 117: 127130.CrossRefGoogle ScholarPubMed
Hua, N, Aquino, P, Owada, CY. Transcatheter closure of perimembranous ventricular septal defects with the amplatzer vascular plug-II. Cardiol Young 2016; 26: 11941201.CrossRefGoogle ScholarPubMed
Shokka, A., Diaa, R, Gebaly, AA, Hossam, WM. Retrograde transcatheter closure of perimembranous aneurysmal ventricular septal defects using amplatzer vascular plug II. J Med Sci Res 2019; 2: 324329.Google Scholar
Diehm, N, Kickuth, R, Silvestro, A et al. Endovascular treatment of an internal iliac artery aneurysm using a nitinol vascular occlusion plug. J Endovasc Ther 2005; 12: 616619.CrossRefGoogle ScholarPubMed
Farra, H, Balzer, DT. Transcatheter occlusion of a large pulmonary arteriovenous malformation using the amplatzer vascular plug. Pediatr Cardiol 2005; 26: 683685.CrossRefGoogle ScholarPubMed
Rossi, M, Rebonato, A, Greco, L et al. A new device for vascular embolization: report on case of two pulmonary arteriovenous fistulas embolization using the amplatzer vascular plug. Cardiovasc Intervent Radiol 2006; 29: 902906.CrossRefGoogle ScholarPubMed