Document Detail


Device closure of ventricular septal defects by hybrid procedures: a multicenter retrospective study.
MedLine Citation:
PMID:  20517999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study reports on the feasibility, efficacy, and outcome of hybrid procedures to close ventricular septal defects (VSD), reflecting the experience of 11 centers in Germany, Austria, and Switzerland.
BACKGROUND: Beating heart closure of VSD has attracted interest in small infants, complex anomalies and postinfarction scenarios where patients are at high risk during surgery. Perventricular or intraoperative device placement allows access to the lesions where percutaneous delivery is limited.
METHODS: Between December 2001 and April 2009, placement of Amplatzer septal occluders was attempted in 26 patients. The defects were located in the perimembranous (n = 5) and muscular septum (n = 21). In 20 patients, a perventricular approach was used, and, in six, the occluders were placed under direct visualization being part of a complex heart surgery.
RESULTS: In 23 of 26 procedures, device placement was successful (88.5%). The mean defect size was 7.8 mm (range, 3.5-20). The occluder types were perimembranous VSD occluder (n = 4), muscular VSD occluder (n = 20), postinfarct VSD occluder (n = 1), and ASD occluder (n = 1) with a ratio device/defect of 0.9-2.4 (median 1.15). Device removal was necessary in three due to arrhythmia, malpositioning, and additional defects. Pericardial effusion occurred once. In the remaining 22 patients, there were no procedure or device-related complications. During mean follow up of 1.4 years (range, 1 day-3.9 years), a residual shunt that was more than trivial was observed in one patient out of 21 successful procedures.
CONCLUSIONS: Perventricular and intraoperative device closure of VSD is as effective as a surgical patch and averts the increased morbidity of conventional surgical repair in a subgroup of high-risk patients.
Authors:
Ina Michel-Behnke; Peter Ewert; Andreas Koch; Harald Bertram; Mathias Emmel; Gunther Fischer; Roland Gitter; Rainer Kozlik-Feldman; Reinald Motz; Erwin Kitzmüller; Oliver Kretschmar;
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-03     Completed Date:  2011-05-23     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-51     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Catheterization / adverse effects,  instrumentation*
Cardiopulmonary Bypass
Child, Preschool
Device Removal
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
Europe
Heart Septal Defects, Ventricular / therapy*,  ultrasonography
Humans
Infant
Infant, Newborn
Patient Selection
Prosthesis Design
Retrospective Studies
Risk Assessment
Septal Occluder Device*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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