Abstract
Objectives: Different devices including Amplatzer duct occluder has been used for percutaneous closure of ventricular septal defects. This study reports our medium term follow up of perimembranous and muscular ventricular septal defects with tunnel shape aneurysm closure using the Amplatzer duct occluder. Materials and Methods: From May 2006-December 2012, we used Amplatzer duct occluder in seven ventricular septal defect patients here atHamad General Hospital,Doha,Qatar. There were 4 male and 3 female patients with an age range of 4 - 32 years with a median of 8 years and weight range of 16 - 63 kgwith a median of33 kg. In this group, 6 were perimembranous and 1 muscular and all these ventricular septal defects had a tunnel shape aneurysm. Transesophageal echocardiographic diameter ranged from 4 - 8 mmand Qp/Qs was 1 - 1.6. Angiographically, the diameter on the left ventricular side measured 3.5 - 10 mmand on right ventricular side 2.4 - 5 mm. 8/6 mmAmplatzer duct occluder was used to close these ventricular septal defects. Results: There were no major complications and immediately after the procedure there was no residual shunt in any of these patients and all the patients remained in normal sinus rhythm. One patient was expatriate and no further follow up was available. The rest of the 6 patients had 1 - 80 months with a median of 54 months follow up and none of these patients had any residual shunt and all remained in normal sinus rhythm. Two patients developed trivial aortic valve regurgitation immediate post procedure, one remained unchanged and the 2nd has progressed to mild at this latest follow up. Conclusion: Amplatzer duct occluder is feasible and a safe device for percutaneous closure of selective tunnel shape aneurysmal perimembranous and muscular ventricular septal defects.
Highlights
Ventricular septal defects (VSDs) are the commonest congenital cardiac malformation accounting for almost one fifth of all defects [1] and can be located in membranous or muscular septum
We have previously reported our initial experience of Amplatzer duct occluder (ADO) to close the VSDs with tunnel shape aneurysm [10]
With the assistance of 0.035 inch Terumo (Radifocus) guide wire, 4 French Judkins right (Cordis) or 4 French Amplatzer right (Cordis J&J) catheter was crossed from the left ventricle (LV) to the right ventricle (RV) and into main pulmonary artery (MPA) in 4 cases and superior vena cava (SVC) in 3 cases based on the wire and catheter feasibility
Summary
Ventricular septal defects (VSDs) are the commonest congenital cardiac malformation accounting for almost one fifth of all defects [1] and can be located in membranous or muscular septum. Eighty percent of these defects are perimembranous involving membranous and adjacent muscular septum. The introduction of Amplatzer family of devices has widened the application of transcatheter techniques for closure of these defects [7,8]. Successful closure of these defects by the device hinges on many factors, on the location/type and the size of the VSD.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
