Transcatheter closure of ventricular septal defect from retrograde transarterial approach: immediate and long-term outcome

Authors

  • Nurun Nahar Fatema Department of Pediatrics, Cardiology, Lab Aid cardiac Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20203639

Keywords:

Closure, Outcome, Retrograde approach, Ventricular septal defect

Abstract

Background: Ventricular septal defect (VSD) is a commonly encountered congenital heart defect. The aim of this study was to analyze five years’ experience with patients who had undergone transcatheter closure of VSD using retrograde transarterial approach.

Methods: It was a retrospective study conducted from December 2014 to December 2019. Cases planned for VSD closure in retrograde approach were included. A total of 147 cases fulfilled the criteria after left ventricular angiography and procedure was performed without forming arteriovenous loop. Follow up was planned at 1, 3, 6, 12 months and yearly thereafter.

Results: The mean age of the patients was 5.94±4.67 years and mean weight was 17.93±8.26 kg. Perimembranous VSD was present in 70.06% cases and the size of the VSD was 5.5±1.8 mm. Amplatzer duct occluder II was the commonest device used (55.24%). Mean device size was 6.2±1.8 (5-8 mm). Complete occlusion was achieved immediately in 94.56% cases, and after one month in 99.36% cases. Four (2.78%) cases were postponed for malpositioning and encroachment of aortic valve. One patient (2.22%) had tiny residual VSD up to 3 years follow up. Bacterial endocarditis was noticed in one patient (0.80%) at one year follow up. No evidence of complete heart block was encountered in follow up period of six to 60 months.

Conclusions: This study recommends that retrograde transarterial approach for closure of moderate to small VSD is safe, effective, and minimally invasive, can be performed in short time with less radiation hazard and less trauma to conducting tissues.

Author Biography

Nurun Nahar Fatema, Department of Pediatrics, Cardiology, Lab Aid cardiac Hospital, Dhaka, Bangladesh

Professor and Head of Pediatrics and Pediatric cardiology, Armed Forces Medical College and CMH Dhaka.

References

Koneti NR, Penumatsa RR, Kanchi V, Arramraj SK, Jaishankar S, Bhupathiraju S. Retrograde transcatheter closure of ventricular septal defects in children using the Amplatzer Duct Occluder II. Catheter Cardiovasc Interv. 2011;77(2):252-9.

Ratnayaka K, Raman VK, Faranesh AZ, Sonmez M, Kim J, Gutiérrez LF, et al. Antegrade Percutaneous Closure of Membranous Ventricular Septal Defect Using X-Ray Fused With Magnetic Resonance Imaging. JACC Cardiovasc Interv. 2009;2(3):224-30.

Butera G, Chessa M, Carminati M. Percutaneous closure of ventricular septal defects. State of the art. J Cardiovasc Med. 2007;8(1):39-45.

Carminati M, Butera G, Chessa M, Drago M, Negura D, Piazza L. Transcatheter closure of congenital ventricular septal defect with Amplatzer septal occluders. Am J Cardiol. 2005;96(12 A):52-8.

Lock JE, Block PC, McKay RG, Baim DS, Keane JF. Transcatheter closure of ventricular septal defects. Circulation. 1988;78(2):361-8.

Fatema NN, Rahman M, Haque M. Device Closure of Ventricular Septal Defect with Amplatzer Muscular Occluder: A Case Report. J Bangladesh Coll Physicians Surg. 2007;25(3):161-3.

Devendran V, Koneti NR, Jesudian V. Transcatheter closure of multiple perimembranous ventricular septal defects with septal aneurysm using two overlapping amplatzer duct occluders II. Pediatr Cardiol. 2013;34(8):1963-15.

Spies C, Ling QC, Hijazi ZM. Transcatheter closure of congenital and acquired septal defects. European Heart J. 2010;12(1):24-34.

Roffman JIE, Kaplan S. The Incidence of Congenital Heart Disease. Am Coll Cardiol. 2002; 39:1890-1900.

Jacobs JP, Burke RP, Quintessenza JA, Mavroudis C. Congenital Heart Surgery Nomenclature and Database Project: ventricular septal defect. Ann Thorac Surg. 2000;69(3):25-35.

Xunmin C, Shisen J, Jianbin G, Haidong W, Lijun W. Comparison of results and complications of surgical and Amplatzer device closure of perimembranous ventricular septal defects. Int J Cardiol. 2007;120(1):28-31.

Butera G, Chessa M, Carminati M. Percutaneous closure of ventricular septal defects. Cardiol Young. 2007;17(3):243-53.

Holzer R, Balzer D, Amin Z, Ruiz CE, Feinstein J, Bass J, et al. Transcatheter Closure of Postinfarction Ventricular Septal Defects Using the New Amplatzer Muscular VSD Occluder: Results of a U.S. Registry. Catheter Cardiovasc Interv. 2004;61(2):196-201.

Butera G, Carminati M, Chessa M, Piazza L, Micheletti A, Negura DG et al. Transcatheter Closure of Perimembranous Ventricular Septal Defects. Early and Long-Term Results. J Am Coll Cardiol. 2007;50(12):1189-95.

Fu YC, Bass J, Amin Z, Radtke W, Cheatham JP, Hellenbrand WE, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer Membranous VSD Occluder: Results of the U.S. phase I trial. J Am Coll Cardiol. 2006;47(2):319-25.

S uligoj B, Cernic N, Zorc M, Noc M, Kar S. Retrograde transcatheter closure of ventricular septal defect with Amplatzer Duct Occluder II. Postep w Kardiol Interwencyjnej. 2016;12(2):177-8.

Polat TB, Türkmen E. Transcatheter closure of ventricular septal defects using the Amplatzer Duct Occluder II device: A single-center experience. Postep w Kardiol Interwencyjnej. 2016;12(4):340-7.

Carminati M, Butera G, Chessa M, Giovanni JD, Fisher G, Gewillig M evert H, et al. Transcatheter closure of congenital ventricular septal defects: Results of the European Registry. Eur Heart J. 2007;28(19):2361-8.

Predescu D, Chaturvedi RR, Friedberg MK, Benson LN, Ozawa A, Lee KJ. Complete heart block associated with device closure of perimembranous ventricular septal defects. J Thorac Cardiovasc Surg. 2008;136(5):1223-8.

Wierzyk A, Szkutnik M, Fiszer R, Banaszak P, Pawlak S, Biakowski J. Transcatheter closure of ventricular septal defects with nitinol wire occluders of type patent ductus arteriosus. Postep w Kardiol Interwencyjnej. 2014;10(1):21-5.

Tanidir IC, Baspinar O, Saygi M, Kervancioglu M, Guzeltas A, Odemis E. Use of LifetechTM Konar-MF, a device for both perimembranous and muscular ventricular septal defects: A multicentre study. Int J Cardiol. 2020;310:43-50.

Fatema NN. Transcatheter Closure of Ventricular Septal Defect Using Detachable Cook Coil. Bangladesh J Cardiol. 2009;1(1):71-4

Fatema N, Rashid H, Azad A. Device Closure of Perimembranous Ventricular Septal Defect Under Deep Sedation and Transthoracic Echo Guide: A Case Report. Cardiovasc J. 2010;3(1):89-91.

Haddad RN, Daou LS, Saliba ZS. Percutaneous closure of restrictive‐type perimembranous ventricular septal defect using the new KONAR multifunctional occluder: Midterm outcomes of the first middle-eastern experience. Catheter Cardiovasc Interv. 2019:ccd.28678.

Shyu TC, Lin MC, Quek YW, Lin SJ, Saw HP, Jan SL, Fu YC. Initial experience of transcatheter closure of subarterial VSD with the Amplatzer duct occluder. J Chinese Med Assoc. 2017;80(8):487-91.

Thanopoulos BD, Tsaousis GS, Karanasios E, Eleftherakis NG, Paphitis C. Transcatheter closure of perimembranous ventricular septal defects with the Amplatzer asymmetric ventricular septal defect occluder: Preliminary experience in children. Heart. 2003;89(8):918-22.

Bass JL, Kalra GS, Arora R, Masura J, Gavora P, Thanopoulos BD et al. Initial human experience with the Amplatzer perimembranous ventricular septal occluder device. Catheter Cardiovasc Interv. 2003;58(2):238-45.

Pass RH, Hijazi Z, Hsu DT, Lewis V, Hellenbrand WE. Multicenter USA amplatzer patent ductus arteriosus occlusion device trial: Initial and one-year results. J Am Coll Cardiol. 2004;44(3):513-9.

Serraf A, Lacour-Gayet F, Bruniaux J,Ouaknine R,Losay J, Petit J, et al. Surgical management of isolated multiple ventricular septal defects: Logical approach in 130 cases. In: Journal of Thoracic and Cardiovascular Surgery. Vol 103. Mosby; 1992:437-43.

ROOSHESSELINK J. Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22?34 years. Eur Heart J. 2004;25(12):1057-62.

Hobbins SM, Izukawa T, Radford DJ, Williams WG, Trusler GA. Conduction disturbances after surgical correction of ventricular septal defect by the atrial approach. Br Heart J. 1979;41(3):289-93.

Danilowicz D, Presti S, Colvin S, Galloway A, Langsner A, Doyle EF. Results of urgent or emergency repair for symptomatic infants under one year of age with single or multiple ventricular septal defect. Am J Cardiol. 1992;69(6):699-701.

Tan CA, Levi DS, Moore JW. Percutaneous closure of perimembranous ventricular septal defect associated with a ventricular septal aneurysm using the Amplatzer ductal occluder. Catheter Cardiovasc Interv. 2005;66(3):427-31.

Kirklin JK, Castaneda AR, Keane JF, Fellows KE, Norwood WI. Surgical management of multiple ventricular septal defects. J Thorac Cardiovasc Surg. 1980;80(4):485-93.

Liang W, Zhou S, Fan T, Song S, Li B, Dong H, et al. Mid term Results of Transaxillary Occluder Device Closure of Perimembranous Ventricular Septal Defect Guided Solely by Transesophageal Echocardiography. Heart Surg Forum. 2019;22(2):112-8.

Bu H, Gao L, Zhang W, Wu Q, JinW, Tang M, et al. Application of perimembranous ventricular septal defects closure solely by femoral vein approach under transesophageal echocardiography guidance. J Cent South Univ (Medical Sci. 2017;42(7):802-7.

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Published

2020-08-25

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Original Research Articles