Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T07:25:21.514Z Has data issue: false hasContentIssue false
  • English
  • Français

Transcatheter closure of perimembranous ventricular septal defects with ductal occluders

Published online by Cambridge University Press:  15 July 2014

Jayaranganath Mahimarangaiah ,
Anand Subramanian ,
Srinivasa Kikkeri Hemannasetty ,
Subhash Chandra ,
Satish Karur ,
Usha Mandikal Kodandaramasastry  and
Manjunath Cholenahally Nanjappa
Jayaranganath Mahimarangaiah
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Anand Subramanian*
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Srinivasa Kikkeri Hemannasetty
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Subhash Chandra
Affiliation:
Department of Cardiology, Manipal Hospitals, Bengaluru, Karnataka, India
Satish Karur
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Usha Mandikal Kodandaramasastry
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Manjunath Cholenahally Nanjappa
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
*
Correspondence to: Dr A. Subramanian, Assistant Professor, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Bengaluru, Karnataka 560 069, India. Tel: 080 22977422; Fax: 080 26534477; E-mail: s_anand80@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: To study the feasibility and complications associated with the use of ductal occluders for closure of perimembranous ventricular septal defects. Methods: A total of 126 patients, ranging from 1 to 41 years of age (median – 8 years), underwent closure of ventricular septal defects from August 2010 to April 2013. Small- and moderate-sized defects were closed using first-generation Patent ductus arteriosus occluders or Amplatzer Duct Occluder-II. Patients were followed up for the development of complications such as heart block, aortic regurgitation, and tricuspid regurgitation. Results: Patent ductus arteriosus occluders were used in 81 patients, and the Amplatzer Duct Occluder-II device in 45 patients. The devices were successfully deployed in 99.2% of the cases. One patient had embolisation of an Amplatzer Duct Occluder-II device soon after deployment. There was one case of transient complete heart block (0.8%) needing temporary pacing, and two cases of isoarrhythmic atrioventricular dissociation (1.6%). One patient developed late-onset complete heart block 15 months after the procedure and underwent permanent pacemaker implantation. There were no instances of new-onset aortic regurgitation. New-onset mild tricuspid regurgitation was seen in two patients. Of the patients, three had small residual shunts on follow-up, without haemolysis. Conclusions: Duct occluders can be used to effectively close small- and moderate-sized ventricular septal defects. The incidence of complete heart block and valvular regurgitations are much less than reported with other devices, and they are cost-effective.

Keywords

Perimembranousventricular septal defectduct occluders
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Supplement 5 , June 2015 , pp. 918 - 926
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Soto, B, Becker, AE, Moulaert, AJ, Lie, JT, Anderson, RH. Classification of ventricular septal defects. Br Heart J 1980; 43: 332–343.Google Scholar
2. Becu, LM, Fontana, RS, DuShane, JW, Kirklin, JW, Burchell, HB, Edwards, JE. Anatomic and pathologic studies in ventricular studies defect. Circulation 1956; 14: 349–364.Google Scholar
3. McDaniel, NL, Gutgesell, HP. Ventricular septal defects. In Allen HD, Driscoll DJ, Shaddy RE, Feltes TF (eds.). Moss and Adams’ Heart Disease in Infants, Children and Adolescents Including the Fetus and Young Adult, 7th edn. Lippincott Williams & Wilkins Inc., Philadelphia, 2008: 667–682.Google Scholar
4. Qin, Y, Chen, J, Zhao, X, et al. Transcatheter closure of perimembranous ventricular septal defect using a modified double-disk occluder. Am J Cardiol 2008; 101: 1781–1786.CrossRefGoogle ScholarPubMed
5. Butera, G, Carminati, M, Chessa, M, et al. Transcatheter closure of perimembranous ventricular septal defects early and long-term results. J Am Coll Cardiol 2007; 12: 1189–1195.Google Scholar
6. Fu, Y-C, Bass, J, Amin, Z, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer Membranous VSD Occluder: results of the US Phase I Trial. J Am Coll Cardiol 2006; 2: 319–325.Google Scholar
7. El Said, HG, Bratincsak, A, Gordon, BM, Moore, JW. Closure of perimembranous ventricular septal defects with aneurysmal tissue using the Amplazter Duct Occluder I: lessons learned and medium term follow up. Catheter Cardiovasc Interv 2012; 80: 895–903.CrossRefGoogle ScholarPubMed
8. Hieu, NL. Transcatheter Closure of Ventricular Septal Defect with New Devices in Vietnam. Proceedings from China Interventional Therapeutics summit, 2010.Google Scholar
9. Bentham, JR, Gujral, A, Adwani, S, Archer, N, Wilson, N. Does the technique of interventional closure of perimembranous ventricular septal defect reduce the incidence of heart block? Cardiol Young 2011; 1: 1–10.Google Scholar
10. Koneti, NR, Penumatsa, R, Kanchi, V, Arramraj, SK, Somaraju Bhupathiraju, JS. Retrograde transcatheter closure of ventricular septal defects in children using the Amplatzer Duct Occluder II. Catheter Cardiovasc Interv 2011; 77: 252–259.Google Scholar
11. Koneti, NR, Sreeram, N, Penumatsa, RR, Arramraj, SK, Karunakar, V, Trieschmann, U. Transcatheter retrograde closure of perimembranous ventricular septal defects in children with the Amplatzer duct occluder II device. J Am Coll Cardiol 2012; 60: 2421–2422.Google Scholar
Supplementary material: File

Mahimarangaiah Supplementary Material

Table

Download Mahimarangaiah Supplementary Material(File)
File 251.9 KB