Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-13T09:41:44.035Z Has data issue: false hasContentIssue false
  • English
  • Français

Transcatheter closure of perimembranous ventricular septal defects with the Amplatzer Vascular Plug-II

Published online by Cambridge University Press:  26 October 2015

Nancy Hua ,
Paolo Aquino  and
Carl Y. Owada
Nancy Hua
Affiliation:
UCSF Fresno Pediatric Residency Program, Fresno, California, United States of America
Paolo Aquino
Affiliation:
Department of Cardiology and Cardiothoracic Surgery, Valley Children’s Hospital, Madera, California, United States of America
Carl Y. Owada*
Affiliation:
Department of Cardiology and Cardiothoracic Surgery, Valley Children’s Hospital, Madera, California, United States of America
*
Correspondence to: Dr C. Y. Owada, MD, Department of Cardiology and Cardiothoracic Surgery, FE-14, Valley Children’s Hospital, 9300 Valley Children’s Place, Madera, CA 93636, United States of America. Tel: (559) 353-5476; Fax: (559) 353-8356; E-mail: cowada@childrenscentralcal.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The aim of this study was to evaluate the safety and efficacy of the Amplatzer Vascular Plug-II used for the closure of perimembranous ventricular septal defects.

Background

There are no FDA-approved transcatheter devices for the closure of perimembranous ventricular septal defects. Several studies have reported on the use of various devices either off-label or under clinical trial protocols. However these reports have described significant adverse events including residual shunts, complete heart block, arrhythmia, and new valve regurgitations. Thus far, no study on the Amplatzer Vascular Plug-II has been reported.

Methods

We conducted a 4-year retrospective chart review from August, 2010 to August, 2014, of patients with perimembranous ventricular septal defects associated with ventricular septal aneurysm who underwent transcatheter closure using the Amplatzer Vascular Plug-II.

Results

A total of 16 patients underwent Amplatzer Vascular Plug-II transcatheter closure of their perimembranous ventricular septal defects. The median age was 2.56 years (range: 0.5–27.3). Their median weight was 13.0 kg (range: 6.9–71.6). The left ventricular median defect size was 9.3 mm (range: 5.9–14.4). The right ventricular median defect size was 3.6 mm (range: 2.3–5.8). All the patients underwent successful device implantation with 83% of the patients having complete echocardiographic closure at the 1-year follow-up; however, one procedure was complicated by early device embolisation. The device was successfully retrieved and replaced with a larger device. There were no device-related outflow tract obstructions, rhythm abnormalities, or haemolysis.

Conclusion

Application of the Amplatzer Vascular Plug-II for closure of perimembranous ventricular septal defects appears to be a safe and effective treatment option. Prospective clinical trials and longer follow-up periods are warranted.

Keywords

Paediatric interventionstranscatheter device closurecongenital heart disease
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1194 - 1201
Check for updates
Copyright
© Cambridge University Press 2015 

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. Meijboom, F, Szatmari, A, Utens, E, et al. Long-term follow-up after surgical closure of ventricular septal defect in infancy and childhood. J Am Coll Cardiol 1994; 24: 1358–1364.Google Scholar
2. Tucker, EM, Pyles, LA, Bass, JL, Moller, JH. Permanent pacemaker for atrioventricular conduction block after operative repair of perimembranous ventricular septal defect. J Am Coll Cardiol 2007; 50: 1196–1200.Google Scholar
3. Yuh, D, Vricella, LA, Yang, S, Doty, J (eds.). Johns Hopkins Textbook of Cardiothoracic Surgery, 2nd edn. McGraw-Hill Education, New York, 2014.Google Scholar
4. Fu, YC, Bass, J, Amin, Z, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial. J Am Coll Cardiol 2006; 47: 319–325.Google Scholar
5. Masura, J, Gao, W, Gavora, P, et al. Percutaneous closure of perimembranous ventricular septal defects with the eccentric Amplatzer device: multicenter follow-up study. Pediatr Cardiol 2005; 26: 216–219.Google Scholar
6. Sullivan, ID. Transcatheter closure of perimembranous ventricular septal defect: is the risk of heart block too high a price? Heart 2007; 93: 284–286.Google Scholar
7. Pinto, RJ, Dalvi, BV, Sharma, S. Transcatheter closure of perimembranous ventricular septal defects using amplatzer asymmetric ventricular septal defect occluder: preliminary experience with 18-month follow up. Catheter Cardiovasc Interv 2006; 68: 145–152.Google Scholar
8. Thanopoulos, BV, Rigby, ML, Karanasios, E, et al. Transcatheter closure of perimembranous ventricular septal defects in infants and children using the Amplatzer perimembranous ventricular septal defect occluder. Am J Cardiol 2007; 99: 984–989.Google Scholar
9. Yang, R, Kong, XQ, Sheng, YH, et al. Risk factors and outcomes of post-procedure heart blocks after transcatheter device closure of perimembranous ventricular septal defect. JACC Cardiovasc Interv 2012; 5: 422–427.Google Scholar
10. Zuo, J, Xie, J, Yi, W, et al. Results of transcatheter closure of perimembranous ventricular septal defect. Am J Cardiol 2010; 106: 1034–1037.CrossRefGoogle ScholarPubMed
11. Lee, SM, Song, JY, Choi, JY, et al. Transcatheter closure of perimembranous ventricular septal defect using Amplatzer ductal occluder. Catheter Cardiovasc Interv 2013; 82: 1141–1146.CrossRefGoogle ScholarPubMed
12. Szkutnik, M, Qureshi, SA, Kusa, J, Rosenthal, E, Bialkowski, J. Use of the Amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart 2007; 93: 355–358.Google Scholar
13. Tzikas, A, Ibrahim, R, Velasco-Sanchez, D, et al. Transcatheter closure of perimembranous ventricular septal defect with the Amplatzer((R)) membranous VSD occluder 2: initial world experience and one-year follow-up. Catheter Cardiovasc Interv 2014; 83: 571–580.Google Scholar
14. Wang, L, Cao, S, Li, J, et al. Transcatheter closure of congenital perimembranous ventricular septal defect in children using symmetric occluders: an 8-year multiinstitutional experience. Ann Thorac Surg 2012; 94: 592–598.Google Scholar
15. Yang, R, Sheng, Y, Cao, K, et al. Transcatheter closure of perimembranous ventricular septal defect in children: safety and efficiency with symmetric and asymmetric occluders. Catheter Cardiovasc Interv 2011; 77: 84–90.Google Scholar