RESUMO
BACKGROUND: The ventricular septal defect (VSD) is the most common form of congenital heart defects. The purpose of this study was to evaluate the results of the early complications and mid-term follow-up of the transcatheter closure of the VSD using the Amplatzer VSD Occluder. METHODS: Between April 2012 and October 2013, 110 patients underwent the percutaneous closure of the perimembranous VSD. During the procedure, the size and type of the VSD were obtained via ventriculography. A device at least 2 mm larger than the VSD diameter measured via ventriculography was deployed. The size of the VSD, size of the Amplatzer, and device-size to VSD-size ratio were calculated. After the confirmation of the suitable position of the device via echocardiography and left ventriculography, the device was released. Follow-up evaluations were done at discharge as well as at 1, 6, and 12 months and yearly thereafter for the VSD occlusion and complete heart block. RESULTS: The study population comprised 62 females and 48 males. The mean age and weight of the patients at procedure were 4.3 ± 5.6 years (range: 2 to 14) and 14.9 ± 10.8 kg (range: 10 to 43). The average device size was 7.0 ± 2.5 mm (range: 4 to 14). The VSD occlusion rate was 72.8% at the completion of the procedure and rose up to 99.0% during the follow-up. The most serious significant complication was complete atrioventricular block, which was seen in 2 patients. The mean follow-up duration was 10.9 ± 3.6 months. CONCLUSION: The transcatheter closure of the perimembranous VSD was a safe and effective treatment with excellent closure rates in our study population. This procedure had neither mortality nor serious complications.
RESUMO
BACKGROUND: The ductus arteriosus connects the main pulmonary trunk to the descending aorta. The incidence of isolated patent ductus arteriosus (PDA) in full-term infants is about 1 in 2000. The Amplatzer Ductal Occluder (ADO) is recommended for PDAs with sizes larger than 2 mm. In this procedure, we must confirm the ADO position in PDA by aortogram from the arterial line. The purpose of this study was to determine the optimal release time of the ADO in the PDA closure procedure, especially in the absence of an arterial line for post-PDA aortography. METHODS: This study recruited all patients scheduled to undergo PDA transcatheter closure with the ADO between September 2009 and September 2012 in our center. Age, weight, PDA diameter, systolic and diastolic pulmonic pressures, fluoroscopy time, and total angiographic time were studied. Major complications such as mortality and vascular complications were considered. RESULTS: We studied 237 patients in our investigation. We had 130 female and 107 male patients at a mean age of 34.3 ± 40.6 months and mean weight of 14.2 ±7.8 kg. PDA sizes ranged from 2.1 to 6.2 mm and its mean was 3.7 ± 1.8 mm. Mean of fluoroscopy time was 11.4 ± 9.7 min and mean of total angiographic time was 42.0 ± 12.3 min. There were no significant complications. CONCLUSION: We herein describe a new sign, which proved extremely helpful during our PDA closure procedures with the ADO. By considering the angle between the ADO and the cable during the procedure, the operator can release the ADO safely.
