Transcatheter closure of ventricular septal defect with various type of occluders : Early and mid-term outcomes

Transcatheter closure of ventricular septal defect with various type of occluders : Early and mid-term outcomes

Transcatheter closure of ventricular septal defect with various type of occluders : Early and mid-term outcomes

(구연):
Release Date : 2017. 10. 27(금)
Kim sung ook, Kim sung ho, Jang so ick, Lee sang yun, Park su jin, Kwon hye won, Choi eun young , Bang ji seok
Sejong General Hospital Pediatrics1
김성옥, 김성호, 장소익, 이상윤, 박수진, 권혜원, 최은영 , 방지석
세종병원 소아청소년과1

Abstract

Objective To investigate the early and mid-term outcomes of transcatheter closure of ventricular septal defect (VSD) with various type of occluders. Background Surgical closure has been a standard treatment method for PM VSD. Transcatheter closure of PM VSD is a challenging procedure Although standard treatment for patients with VSDs has been a surgical closure, transcatheter closure could be an alternative option. However, high incidence of complete atrioventricular block (CAVB) has been reported in the initial trials of transcatheter closure of perimembranous( PM) VSD. There have been many reports showing comparable results as surgical treatment regarding CAVB. They used modified VSD occluders or other devices such as Amplatzer ductal occluder (ADO) Ⅰand II. We have used ADO Ⅰand II, Amplatzer muscular VSD occluder (AMVO), Amplatzer septal occluder (ASO), Occlutech PDA Occluder (OPO), and Cocoon ventricular septal occluder (CVSO) for it. Methods Between May 2009 and May 2017, fifty eight patients (28 males and 30 females) underwent transcatheter closure of VSD using ADO I (34), ADO II (4), CVSO (12), AMVO (4), OPO (2), and ASO ( 2) in our hospital. We retrospectively reviewed the data. Results The age of patients ranged from 2 to 65 years (mean 15 years), with body weight from 8 to 66 kg (mean 34kg). Most patients showed echocardiographic signs of left ventricular volume overload and trivial to small mitral regurgitation (Qp/Qs = 1.6 ± 0.6). The mean defect size of VSD at the right ventricular side was 4.6 ± 2.7 mm. 33 of 58 patients could be followed up because 25 patients were foreigner, and the mean follow-up period was 11.3 ± 14.6 months. VSD types were PM VSD in 24 and muscular VSD in 21. All devices were successfully implanted in all patients except 2 who showed device migration immediately after the device implantation (ADO). Trivial residual shunts were observed in 4 patients. CAVB or aortic regurgitation was not observed in any patients during follow-up period. Conclusion Transcatheter closure of VSD with the various type of occluders is a feasible and efficient treatment option, although long-term follow up is warranted to establish it.

Keywords: VSD, transcatheter closure,