Transcatheter Closure of Perimembranous Ventricular Septal Defects in Infants and Children Using the Amplatzer Perimembranous Ventricular Septal Defect Occluder

• Published in: The American journal of cardiology Vol. 99; no. 7; pp. 984 - 989
• Main Authors: Thanopoulos, Basil (Vasilios) D., MD, PhD, Rigby, Michael L., MD, Karanasios, Evangelos, MD, Stefanadis, Christodoulos, MD, Blom, Nico, MD, Ottenkamp, Jaap, MD, Zarayelyan, Armine, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2007; Elsevier; Elsevier Limited
• Subjects: Adolescent; Babies; Biological and medical sciences; Cardiac Catheterization - adverse effects; Cardiac Catheterization - instrumentation; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Catheters; Child; Child, Preschool; Children & youth; Clinical outcomes; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Equipment Design; Equipment Failure; Europe; Follow-Up Studies; Heart; Heart Septal Defects, Ventricular - diagnostic imaging; Heart Septal Defects, Ventricular - therapy; Humans; Infant; Medical sciences; Patients; Pediatrics; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Research Design; Transplants & implants; Treatment Outcome; Ultrasonic imaging; Human; Ventricular septal defect; Closure; Instrumentation therapy; Cardiovascular disease; Infant; Intracardiac defect; Instrumental obliteration; Congenital disease; Phlebology; Malformation; Heart disease; Circulatory system; Cardiology; Child
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2006.10.062

There are very few published reports of the transcatheter closure of perimembranous ventricular septal defects (PMVSDs) using the Amplatzer PMVSD occluder with encouraging initial results. This report presents initial and 1-year results from 54 patients with PMVSDs who underwent transcatheter closure at 5 different institutions with the Amplatzer PMVSD occluder. Sixty-five patients with PMVSDs were enrolled at 5 European centers. Eleven of the 65 patients did not fulfill the patient selection criteria at the initial echocardiographic evaluation or at cardiac catheterization. As a result, a total of 54 patients underwent attempted transcatheter closure using the Amplatzer PMVSD occluder. The median age of the patients was 5.1 ± 3.6 years (range 0.3 to 13), and the median weight 18.5 ± 10.3 kg (range 5 to 45). Devices were permanently implanted in 49 of 54 patients. Complete occlusion of the communication at 1-year follow-up was observed in 46 of 49 patients (94%). Main early procedural complications included (1) device embolization (2 patients), (2) severe bradycardia with hemodynamic compromise (2 patients), and (3) Mobitz II (2:1) heart block (1 patient). Late procedural complications included complete heart block (1 patient). No other complications were observed during follow-up. In conclusion, the Amplatzer PMVSD occluder is promising device that can be used for transcatheter closure in selected patients with PMVSDs. Further studies and long-term follow-up are required before this technique enters routine clinical practice.