Premium
Transcatheter closure of postsurgical residual ventricular septal defects: Early and mid‐term results
Author(s) -
Dua Jaspal S,
Carminati Mario,
Lucente Mariella,
Piazza Luciane,
Chessa Massimo,
Negura Diana,
Bussadori Claudio,
Saliba Zakhia,
Butera Gianfranco
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22262
Subject(s) - medicine , cardiology , percutaneous , tetralogy of fallot , cardioversion , ventriculotomy , sinus rhythm , surgery , atrial flutter , heart septal defect , heart block , ventricle , atrial fibrillation , heart disease , electrocardiography
Background: The incidence of residual ventricular septal defects (VSDs) after surgery is 5–25%. Redo surgery is associated with higher risks. Methods: Between January 2000 to December 2008, 170 patients underwent percutaneous VSD closure in our centre: 22(16M) of these had 23 closures for residual VSDs. Median age was 32.5 yrs (1.4–79). All patients had echocardiographic signs of left ventricle volume overload ( Q p / Q s ≥ 1.5). Nine patients had previous VSD closure, 6 tetralogy of Fallot repair, and 7, other procedures. There were 15 muscular, 6 perimembranous and 2 apical VSDs. Results: Amplatzer VSD devices were used in all. Median VSD size was 8 mm (4.3–16). Median fluoroscopy time was 33 minutes (15–130). There were three adverse events: 1 ventricular fibrillation requiring DC cardioversion; 1 transient complete atrio‐ventricular block reverting to sinus rhythm at 24‐hours; one patient had transient atrial flutter during the procedure. All procedures were successful; no additional procedures were required. Trivial residual shunts were seen in 3 patients at follow‐up. There were no late events. One patient experienced arrhythmic death 5‐yrs after procedure. One patient was reoperated due to dehiscence of VSD patch 2‐yrs after the second successful percutaneous closure. Conclusions: Transcatheter closure of postsurgical residual VSD is safe and efficacious management option and obviates the need for further surgery and by‐pass. © 2009 Wiley‐Liss, Inc.