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Retrograde transcatheter closure of ventricular septal defects in children using the Amplatzer Duct Occluder II
Author(s) -
Koneti Nageswara Rao,
Penumatsa Raghava Raju,
Kanchi Vasudevan,
Arramraj Srinivas Kumar,
S. Jaishankar,
Bhupathiraju Somaraju
Publication year - 2011
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.22675
Subject(s) - medicine , fluoroscopy , surgery , abnormality , heart septal defect , cardiac catheterization , cardiology , psychiatry
Objectives: To describe the technique and results of transcatheter closure of ventricular septal defects (VSDs) by a modified retrograde transarterial approach using the new Amplatzer Duct Occluder II (ADO II). Background: Transcatheter device closure of ventricular septal defects (VSDs) by antegrade method is well established, but a challenging procedure. We describe a retrograde technique that obviates the need for arteriovenous looping. Material and Methods: This is a prospective study from a single center. Between April 2009 and February 2010 13 children were identified for closure of various types of perimembranous and muscular VSDs using the ADO II device. All had met the criteria for surgical closure. Following left ventricular angiogram two were excluded as technically nonfeasible. The median age was 48 months (range 15–78). The median weight was 14 kg (range 7.5–20). The device was successfully deployed in the 11 selected children by the method described. The follow‐up evaluation included chest roentgenogram, ECG, and echocardiogram on day 1, at 6 weeks, at 3, 6, and 12 months. Results: The immediate and follow up complete closure rates were 73 and 82%, respectively. The median fluoroscopic time was 14 min (range 8.2–45). There were no procedure related complications. All patients were doing well at median follow up of 10 months; none showing any conduction abnormality. Conclusion: Transcatheter retrograde device closure of selected cases of Ventricular Septal Defects using the Amplatzer Duct Occluder II is simple and appears safe in the short term and can be completed within a short fluoroscopic time.© 2010 Wiley‐Liss, Inc.