eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 14
Short communication

Percutaneous closure of perimembranous and postsurgical ventricular septal defects with Amplatzer Duct Occluder II Additional Sizes in paediatric patients – case series

Mateusz T. Knop, Linda Litwin, Małgorzata Szkutnik, Jacek Białkowski, Michal Galeczka, Roland Fiszer

Adv Interv Cardiol 2018; 14, 4 (54): 429–432
Online publish date: 2018/12/11
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Perimembranous ventricular septal defect (pmVSD), one of the most frequent congenital heart defects, requires surgical (gold standard) or transcatheter closure in a considerable number of children. In general, the results of surgical correction are excellent; however, in 2.5% of patients residual postsurgical VSDs (psVSD) are reported [1]. There have been numerous attempts to close pmVSD with various devices, with different efficacy and safety rates [2]. The percutaneous closure of psVSD, sometimes of atypical anatomy, was also reported in the literature [3]. The transcatheter treatment of pmVSD remains a controversial problem. The main issues are the risk of embolization, early and late conduction disturbances, damage to the tricuspid valve apparatus or aortic insufficiency [4]. Numerous devices have been proposed for percutaneous pmVSD closure, including the off-label use of Amplatzer muscular VSD occluders, Amplatzer duct occluders type I and II (ADO I, II) or ADOII Additional Sizes (ADO II AS) [2, 5–7]. To the best of our knowledge, there have been only two previous publications from this and the previous year regarding this application of ADO II AS in children – 1 case report [6] and 1 presentation of a series of 4 cases [7].


To present our preliminary experience with ADO II AS used for the transcatheter closure of 4 pmVSDs and 2 psVSDs.

Material and methods

All patients were qualified for percutaneous VSD closure by a team of paediatric cardiologists and cardiac surgeons based on clinical symptoms of increased pulmonary flow (chest X-ray) and/or echocardiographic signs of LV volume overload. All patients had a Qp/Qs ratio > 1.5. Written informed consent was obtained from the parents prior to the procedures.


ADO II AS (St. Jude Medical, Inc., USA) is a device originally designed for arterial duct closure. Briefly, it is a symmetrical, self-expanding, single mesh layer Nitinol occluder. There are three different waist-disc diameters available (3 mm – 4 mm, 4 mm – 5.25 mm, 5 mm – 6.5 mm), each available with three different waist lengths (2, 4 and 6 mm). A dedicated Amplatzer TorqVue LP 4 French catheter is recommended for the deployment procedure. ADO II AS and its dedicated delivery catheter are characterized by soft construction – this feature is of special importance due to procedural manoeuvres carried out in the proximity of the conduction system and...

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Scully BB, Morales DL, Zafar F, et al. Current expectations for surgical repair of isolated ventricular septal defects. Ann Thorac Surg 2010; 89: 544-51.
Saurav A, Kaushik M, Mahesh Alla V, et al. Comparison of percutaneous device closure versus surgical closure of peri-membranous ventricular septal defects: a systematic review and meta-analysis. Catheter Cardiovasc Interv 2015; 86: 1048-56.
Zhou W, Li F, Fu L, et al. Clinical experience of transcatheter closure for residual ventricular septal defect in pediatric patients. Congenit Heart Dis 2016; 11: 323-31.
Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J 2007; 28: 2361-8.
Szkutnik M, Qureshi SA, Kusa J, et al. Use of the Amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart 2007; 93: 355-8.
Champaneri B, Kappanayil M, Kumar RK. Transcatheter closure of membranous septal defect in a 1,8-kg infant using Amplatzer Duct Occluder II additional size device. Cardiol Young 2017; 27: 1437-40.
Narin N, Tuncay A, Baykan A, et al. Percutaneous ventricular septal defect closure in patients under 1 year of age. Pediatr Cardiol 2018; 39: 1009-15.
Fiszer R, Chojnicki M, Szkutnik M, et al. Are the AMPLATZER duct occluder II additional sizes devices dedicated only for smaller children? EuroIntervention 2017; 12: 2100-3.
Walsh MA, Bialkowski J, Szkutnik M, et al. Atrioventricular block after transcatheter closure of perimembranous ventricular septal defects. Heart 2006; 92: 1295-7.
El Said, Howaida G, Bratincsak A, et al. Closure of perimembranous ventricular septal defects with aneurysmal tissue using the Amplazter duct occluder I: lessons learned and medium term follow up. Cathet Cardiovasc Interv 2012; 80: 895-903.
El-Sisi A, Sobhy R, Jaccoub V, Hamza H. Perimembranous ventricular septal defect device closure: choosing between Amplatzer duct occluder I and II. Pediatr Cardiol 2017; 38: 596-602.
Wierzyk A, Szkutnik M, Fiszer R, et al. Transcatheter closure of ventricular septal defects with nitinol wire occluders of type patent ductus arteriosus. Adv Intev Cardiol 2014; 10: 21-5.
Polat TB, Turkmen E. Transcatheter closure of ventricular septal defects using the Amplatzer duct occluder II device: a single-center experience. Adv Interv Cardiol 2016; 12: 340-7.
Pamukcu O, Narin N, Baykan A, et al. Mid-term results of percutaneous ventricular septal defect closure with Amplatzer duct occluder-II in children. Cardiol Young 2017; 27: 1726-31.
Haas NA, Kock L, Bertram H, et al. Interventional VSD-closure with the Nit-Occlud® Lê VSD-Coil in 110 patients: early and midterm results of the EUREVECO-registry. Pediatr Cardiol 2017; 38: 215-27.
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