title: Catheter therapy of Swiss cheese ventricular septal defects using the Amplatzer muscular VSD occluder.
abstract: The medical and surgical management of patients with multiple muscular ventricular septal defects (VSDs) is associated with morbidity and mortality. Three children with Swiss cheese VSDs were treated with transcatheter occlusion of their multiple defects using the Amplatzer muscular VSD occluder. Seventeen defects were closed in five catheterization procedures. One patient had three devices placed in two procedures, the second had five defects closed in one procedure, and the third had nine defects closed in two procedures. Two patients had previously been treated with pulmonary artery banding and required subsequent surgical band removal. There was immediate reduction in the left-to-right shunting and clinical improvement in all patients. Complications included the need for blood transfusion during the two longest procedures and tricuspid valve regurgitation in one. Transcatheter occlusion of multiple VSDs is an acceptable alternative or adjunct to surgical therapy for these complex patients.
authors.affiliation: Section of Pediatric Cardiology, Department of Pediatrics, University of Chicago Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Waight
authors.forename: Emile A
authors.initials: EA
authors.lastname: Bacha
authors.forename: Madelyn
authors.initials: M
authors.lastname: Kahana
authors.forename: Qi-Ling
authors.initials: QL
authors.lastname: Cao
authors.forename: Mary
authors.initials: M
authors.lastname: Heitschmidt
authors.forename: Ziyad M
authors.initials: ZM
authors.lastname: Hijazi
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome