title: Percutaneous closure of ventricular septal defects in children aged <12: early and mid-term results.
abstract: OBJECTIVE
  The aim of the article is to study the safety, efficacy, and follow-up of percutaneous closure of muscular ventricular septal defect (mVSD) and perimembranous ventricular septal defect (pmVSD) in children.
  
  
  RESULTS
  Between January 2000 and June 2005, among 140 patients who underwent percutaneous closure of an mVSD or a pmVSD, 88 were aged lt;12. Two different Amplatzer devices were used: the mVSD occluder and the pmVSD occluder. Mean age and weight at procedure were 4.5+/-3.3 years and 18.7+/-11.2 kg, respectively. Percutaneous closure was successfully achieved in 83 subjects (94%). No deaths occurred. Thirteen patients (14.7%) had early complications: device embolization (n=4), vascular complications (n=3), and rhythm abnormalities (n=6). These were transient complications in all but one case [1.1% complete atrioventricular block (cAVB) needing pacemaker implantation]. During a median follow-up of 24 months, three subjects treated for a pmVSD needed pacemaker implantation due to the occurrence of cAVB. Multivariable analysis using Cox's proportional hazard regression showed that age was the only risk factor associated with the occurrence of cAVB (P=0.028; relative risk: 0.25).
  
  
  CONCLUSIONS
  Percutaneous closure of mVSD and pmVSD in children can be performed safely and successfully. The occurrence of cAVB is a major concern in young children with pmVSD.
authors.affiliation: Department of Pediatric Cardiology and Cardiac Surgery, Istituto Policlinico San Donato, Via Morandi, 30, 20097 San Donato Milanese, Italy. gianfra.but@lycos.com
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Butera
authors.forename: Mario
authors.initials: M
authors.lastname: Carminati
authors.forename: Massimo
authors.initials: M
authors.lastname: Chessa
authors.forename: Luciane
authors.initials: L
authors.lastname: Piazza
authors.forename: Raul
authors.initials: R
authors.lastname: Abella
authors.forename: Diana Gabriella
authors.initials: DG
authors.lastname: Negura
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giamberti
authors.forename: Bussadori
authors.initials: B
authors.lastname: Claudio
authors.forename: Angelo
authors.initials: A
authors.lastname: Micheletti
authors.forename: Youssef
authors.initials: Y
authors.lastname: Tammam
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frigiola
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology; D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006327:Heart Block / Q000209:etiology; D006345:Heart Septal Defects, Ventricular / Q000628:therapy*; D006349:Heart Valve Diseases / Q000209:etiology; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome