Wyniki przezskórnego zamknięcia ubytku typu Gerbode z zastosowaniem Nit-Occlud Le VSD (PFM) coil.

Abstract

Introduction: Left ventricle-to-right atrial (LV-RA) communications termed Gerbode defects are a special and very rare type of ventricular septal defects. Transcatheter closure using Nit-Occlud Le VSD-coils is a new and not well-known alternative to cardiac surgery in selected cases. The aim of our study was to describe results and our experience with interventional closure of Gerbode defects using Nit-Occlud Le VSD-Coil. Material and Methods: The procedures were performed between October 2014 and October 2018. Patients were selected based on detailed transthoracic echocardiography (TTE). The diameter of the defects based on the TTE study was verified and comparable to values found in the angiocardiography. Despite of the fluoroscopy guidance the intraprocedural transesophageal echocardiography was carried out in every case. Finally, the effectiveness of the procedure and the occurrence of complications during the observation were assessed in each case. Results: The study involved eight children, including an infant with native Gerbode defect and seven older children with acquired post-operative LV-RA shunts. Age ranged from 8 months to 17.8 years, body weight from 7.4 kg to 56 kg, body weight from 7.4 kg to 56 kg, 5/8 females. The diameter mean of the defects in the angiocardiography was 3.86±0.82 mm and it was comparable to values from TTE. All procedures were successful. The coils ranged from 8x6 mm to 12x6 mm. Early complications after procedure: one case of a transient haemolysis which required blood transfusion and steroids, one case of temporary arrhythmia. The follow-up period ranged 2-36 months, with only one case of a permanent small residual shunt was observed. Conclusions: The interventional treatment of very rare Gerbode defect seems to be a safe alternative to surgery in selected cases. This study is one of the largest suchlike published.