Outcome of transcatheter closure of muscular ventricular septal defects with the Amplatzer ventricular septal defect occluder.
OBJECTIVE
To present further experience and intermediate term outcome in 30 patients with single muscular ventricular septal defects (MVSDs) who underwent transcatheter closure with the Amplatzer ventricular septal defect occluder (AVSDO).


METHODS
Thirty patients, aged 4 months to 16 years, with MVSDs underwent transcatheter closure with the AVSDO. The device consists of two low profile disks made of Nitinol wire mesh with a 7 mm connecting waist. The prosthesis size (waist diameter) was selected to be equal to the balloon "stretched" diameter of the defect. A 7-9 French sheath was used to deliver the AVSDO. Fluoroscopy and transoesophageal echocardiography guided the procedure.


RESULTS
The stretched diameter of the defects ranged from 6-14 mm. The communication was completely occluded in 28 of 30 patients (93% closure rate). One patient (a 4 month old infant) with sustained complete left bundle branch block after the procedure went on to develop complete heart block one year later. No other complications were observed during a mean follow up of 2.2 years (range 0.25-4.5 years).


CONCLUSIONS
The AVSDO is an efficient prosthesis that can be safely used in the majority of patients with a single MVSD. Further studies are required to establish long term results in a larger patient population.
Thanopoulos
B D
BD
Department of Paediatric Cardiology, Aghia Sophia Children's Hospital, Thivon and Levadias Street, Athens 115 27, Greece. vasiliosthanopoulos@usa.net
Rigby
M L
ML
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005471:Fluoroscopy; D006327:Heart Block / Q000209:etiology; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D019736:Prostheses and Implants / Q000009:adverse effects; D011474:Prosthesis Design; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods