Document Detail

Outcomes of a modified approach to transcatheter closure of perimembranous ventricular septal defects.
MedLine Citation:
PMID:  23225758     Owner:  NLM     Status:  Publisher    
OBJECTIVES: To describe the immediate and midterm results of a modified method for transcatheter closure of pmVSDs. BACKGROUND: Transcatheter closure of pmVSDs has been associated with development of heart block due to impingement upon the ventricular conduction system. Ventricular septal aneurysms (VSAs) are common; the VSA tissue can serve as a target for the device without necessitating direct contact with the conduction system. METHODS: Between 2004 and 2011, 15 patients underwent transcatheter closure of a pmVSD utilizing a device implanted into a VSA. Catheterization reports were examined in addition to pre-closure, post-closure, and current clinical, ECG, and echocardiographic data. RESULTS: The median age was 20 yr (4-61 yr), and the most common indication for closure was increasing LV dilation. Four different Amplatzer devices were utilized. Following device implantation there was a decrease in Qp:Qs (1.7 to 1.1) and in RV:LV pressure ratio (0.36 to 0.31). There were no deaths, no device embolizations, and no new heart block or PR prolongation. Three patients developed a new RBBB. The median follow-up time was 1.5 yr (4 mo-7.1 yr). Two patients required further procedures for important residual shunting. Six continued to have a "trivial/small" residual leak, but only one had any degree (mild) of residual LV dilation. None of the complications were significantly associated with age or weight at the time of procedure, original size of the VSD, or size or type of the device used. CONCLUSION: Transcatheter closure of pmVSD with placement of the device into the VSA is safe and effective, and may result in fewer instances of AV block and valve abnormalities than have been reported with alternative methods of pmVSD device closure. Persistent VSDs and new RBBBs remain an important issue. © 2012 Wiley Periodicals, Inc.
Geri Landman; Alaina Kipps; Phillip Moore; David Teitel; Jeffery Meadows
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-7
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
University of California San Francisco.
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