Abstract
1/2008
vol. 4
Original articleShould perimembranous ventricular septal defects still be treated percutaneously?
Post Kardiol Interw 2008; 4, 1 (11): 1–9
Online publish date: 2008/04/10
Aim: Assessment of perimembraneous ventricular septal defects (VSD) treatment with the use of AMembrVSDO and evaluation of the early and late complication risk. Methods: In the period from June, 2003 to August, 2005, 17 patients were qualified for VSD transcatheter closure. Patients aged 1.2-18.0 years (mean 9.2±6.5), weighted 9.4-72.0 kg (mean 32.9±21.8). The follow-up period was 3-4 years.
Results: The procedure was performed successfully in 15 out of 17 children. The left ventricle end-diastolic dimension decreased statistically after the procedure (p=0.00005). One child (6.7%) suffered from a complete atrioventricular block after the VSD closure. Minor complications were observed in 4 (26.7%) cases. Statistically significant differences were observed between the size of the device and the short diameter of the VSD (p=0.7600), the long diameter of the VSD (p=0.8152), the angiographic diameter of the VSD (p=0.9210) as well as the proposed device (p=0.9202). After VSD closure, the number of patients with TI >I° decreased from 66.7% to 6.7% (p=0.0159) and, in case of those with MI, from 93.3% to 60% (p=0.0270).
Conclusion: Percutaneous closure of the perimembranous VSD with AMembrVSDO is a promising method of treatment. Nevertheless, more frequent occurrence of the complete heart block following the above-mentioned procedure in comparison to surgery indicates that the qualification for AMembrVSDO implantation should be performed very carefully. More data is needed to verify safety of this procedure.
Keywords
perimembranous ventricular septal defect, Amplatzer, transcatheter occlusion
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