[Percutaneous occlusion of interventricular septal defects. Initial experiment].
OBJECTIVE
To assess the initial experiment with percutaneous closure of interventricular septal defects (IVSD), especially perimembranous IVSD (PMIVSD) with the new Amplatzer prosthesis.


METHODS
Eleven patients were submitted to the procedure. Six of them had perimembranous IVSD (PMIVSD) and five with muscular IVSD (MIVSD). Two showed repeated respiratory tract infections and had low ponderal gain. One of them showed a previous history of infectious endocarditis. The others were asymptomatic and were selected through transthoracic echocardiography (TTE).


RESULTS
In MIVSD group (n = 5), a patient had apical IVSD, two had medioseptal defects and two patients showed multiple defects. In this group, an interatrial septal defects (IASD) (Amplatzer Septal Occluder) and five prostheses for MIVSD (Amplatzer VSD-MUSC Occluder), and one patient received two devices. All implants were well-succeeded and went by without complications. In PMIVSD group (n = 6), two patients had membranous septal aneurysms. In five, we identified two orifices with selective angiography. We used arterial canal Amplatzer prostheses (ACP) (Amplatzer Duct Occluder) in 1 patient and specific prostheses for PMIVSD in the others (Amplatzer VSD-MEMB Occluder). A perimembranous occluder migrated immediately after released, being removed from the descending aorta. Another patient showed total atrioventricular block (TAVB), which reversed after corticotherapy.


CONCLUSIONS
The procedure is technically complex and must be performed only in specialized centers. Despite of that, it showed safe and efficient in the selected cases, and it can be provided as an alternative to traditional surgical treatment.
Queiróz
Francisco José Araújo Chamié de
FJ
Cardiologia Pediátrica e Fetal do Rio de Janeiro, Rio de Janeiro, RJ. fchamie@pobox.com
Rossi Filho
Raul Ivo
RI
Ramos
Sérgio
S
Esteves
César
C
Queiróz
Daniel Silva Chamié de
DS
Machado
Paulo Renato
PR
Tress
João Carlos
JC
Horowitz
Stella Suzana
SS
Paupério
Helder
H
Victer
Rosaura
R
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome