The transcatheter closure of intracristal and subpulmonary ventricular septal defect / 介入放射学杂志

ABSTRACT

Objective To assess the efficacy and safety of transcatheter closure of intracristal ventricular septal defect (IVSD) and subpulmonary ventricular septal defect(SVSD)with home-made eccentric nitinol occluder.Methods Transcatheter closure was attempted in 28 patients (15 men and 13 women), with IVSD(n=22)and SVSD(n=6) at a age of 12.44?5.86 years (ranged from 3 to 34 years of age) The homemade device consists of two low profile disks made of Nitinol wire mesh with a 2 mm connecting waist. The left disk is 6 mm towards the apex and 0 mm towards the aortic valve. The right disk is 4 mm larger than the waist. The devices were deployed via the femoral vein using 7-10 Fr sheaths with the guidance of transthoracic echocardiography and fluoroscopy. Results The VSD diameter was 4.54 ?1.93 mm (ranged 2 to 12 mm). the distance of VSD to aortic valve was 0.35?045 mm (range 0 to 1 mm )。The connecting waist diameter of device was 7.65?3.11 mm(ranged 4 to 14 mm). The device was implanted successfully in 26 of 28 procedures. There was a trivial aortic regurgtation in 1 patient with SVSD after deployment of the occluder. Implantation was unsuccessful in 2 patients with SVSD, with having large defects. No other complications were observed. The mean fluoroscopy time for the procedure was 14.07?5.19 min (range 9 to 40 min). The procedure time was 59.81?17.76 min (range 40 to 150 min).Conclusions Transcatheter closure of IVSD and SVSD with homemade eccentric nitinol occluder is effective, easy and safe.Longer follow-up is required to assess long-term efficacy.