Medtronic microvascular plug™: A multipotent device for transcatheter occlusions in children with congenital heart disease

Abstract

To evaluate our experience with the MVP™ Microvascular Plug system for embolizations of vascular abnormalities in children with congenital heart diseases (CHD). The MVP™ is a recent valuable addition to the armamentarium for vascular embolization. Data on its use in pediatric and congenital cardiology is scarce. Medical records and catheterization reports of all children with CHD who had attempted transcatheter embolizations with MVP™ between April 2015 and September 2020 were retrospectively reviewed. Type of lesions, immediate procedural outcomes, and follow-up data were assessed. A total of 153 patients underwent 172 procedures during which 240 vessel embolizations using 259 MVP™ were attempted. Median age and weight were 34.9 months and 12.5 kg, respectively. Two devices were deployed at the same site in 14 cases. Seven devices were removed before release. Procedural success rate was 99.2%. Target vessels anomalies were systemic arteries ( n = 163), patent arterial duct ( n = 26), venous ( n = 45), and coronaro-cameral fistulae ( n = 6). Mean vessel diameter was 3.3 ± 1.1 mm (1.4 to 9 mm). A detailed device selection chart according to vessel type and diameter was presented based on our experience ( Table 1 ). Complete closure rate was 94.4% at the end of the procedure and increased up to 100% across follow-up. Major complications were limited to one device migration requiring surgery and 4 embolizations treated with percutaneous retrieval. Safety and efficacy of abnormal vessel embolization using the MVP™ were demonstrated in the largest cohort of children with CHD and in a variety of applications. The major advantages of the MVP™ are smooth delivery with high procedural flexibility leading to immediate and stable closure with a single device in most cases, potentially reducing duration, radiation exposure, and decreasing the size of the sheath used in small children.