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Transcatheter closure of perimembranous ventricular septal defects with ductal occluders

Published online by Cambridge University Press:  15 July 2014

Jayaranganath Mahimarangaiah ,
Anand Subramanian ,
Srinivasa Kikkeri Hemannasetty ,
Subhash Chandra ,
Satish Karur ,
Usha Mandikal Kodandaramasastry  and
Manjunath Cholenahally Nanjappa
Jayaranganath Mahimarangaiah
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Anand Subramanian*
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Srinivasa Kikkeri Hemannasetty
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Subhash Chandra
Affiliation:
Department of Cardiology, Manipal Hospitals, Bengaluru, Karnataka, India
Satish Karur
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Usha Mandikal Kodandaramasastry
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Manjunath Cholenahally Nanjappa
Affiliation:
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
*
Correspondence to: Dr A. Subramanian, Assistant Professor, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Bengaluru, Karnataka 560 069, India. Tel: 080 22977422; Fax: 080 26534477; E-mail: s_anand80@hotmail.com
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Abstract

Background: To study the feasibility and complications associated with the use of ductal occluders for closure of perimembranous ventricular septal defects. Methods: A total of 126 patients, ranging from 1 to 41 years of age (median – 8 years), underwent closure of ventricular septal defects from August 2010 to April 2013. Small- and moderate-sized defects were closed using first-generation Patent ductus arteriosus occluders or Amplatzer Duct Occluder-II. Patients were followed up for the development of complications such as heart block, aortic regurgitation, and tricuspid regurgitation. Results: Patent ductus arteriosus occluders were used in 81 patients, and the Amplatzer Duct Occluder-II device in 45 patients. The devices were successfully deployed in 99.2% of the cases. One patient had embolisation of an Amplatzer Duct Occluder-II device soon after deployment. There was one case of transient complete heart block (0.8%) needing temporary pacing, and two cases of isoarrhythmic atrioventricular dissociation (1.6%). One patient developed late-onset complete heart block 15 months after the procedure and underwent permanent pacemaker implantation. There were no instances of new-onset aortic regurgitation. New-onset mild tricuspid regurgitation was seen in two patients. Of the patients, three had small residual shunts on follow-up, without haemolysis. Conclusions: Duct occluders can be used to effectively close small- and moderate-sized ventricular septal defects. The incidence of complete heart block and valvular regurgitations are much less than reported with other devices, and they are cost-effective.

Keywords

Perimembranousventricular septal defectduct occluders
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Supplement 5 , June 2015 , pp. 918 - 926
Copyright
© Cambridge University Press 2014 

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