title: Transcatheter closure of perimembranous ventricular septal defects in infants and children using the Amplatzer perimembranous ventricular septal defect occluder.
abstract: There are very few published reports of the transcatheter closure of perimembranous ventricular septal defects (PMVSDs) using the Amplatzer PMVSD occluder with encouraging initial results. This report presents initial and 1-year results from 54 patients with PMVSDs who underwent transcatheter closure at 5 different institutions with the Amplatzer PMVSD occluder. Sixty-five patients with PMVSDs were enrolled at 5 European centers. Eleven of the 65 patients did not fulfill the patient selection criteria at the initial echocardiographic evaluation or at cardiac catheterization. As a result, a total of 54 patients underwent attempted transcatheter closure using the Amplatzer PMVSD occluder. The median age of the patients was 5.1+/-3.6 years (range 0.3 to 13), and the median weight 18.5+/-10.3 kg (range 5 to 45). Devices were permanently implanted in 49 of 54 patients. Complete occlusion of the communication at 1-year follow-up was observed in 46 of 49 patients (94%). Main early procedural complications included (1) device embolization (2 patients), (2) severe bradycardia with hemodynamic compromise (2 patients), and (3) Mobitz II (2:1) heart block (1 patient). Late procedural complications included complete heart block (1 patient). No other complications were observed during follow-up. In conclusion, the Amplatzer PMVSD occluder is promising device that can be used for transcatheter closure in selected patients with PMVSDs. Further studies and long-term follow-up are required before this technique enters routine clinical practice.
authors.affiliation: Department of Cardiology, Aghia Sophia Children's Hospital, and University of Athens, Greece. vasiliosthanopoulos@usa.net
authors.forename: Basil Vasilios D
authors.initials: BV
authors.lastname: Thanopoulos
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rigby
authors.forename: Evangelos
authors.initials: E
authors.lastname: Karanasios
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.forename: Nico
authors.initials: N
authors.lastname: Blom
authors.forename: Jaap
authors.initials: J
authors.lastname: Ottenkamp
authors.forename: Armine
authors.initials: A
authors.lastname: Zarayelyan
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D004868:Equipment Failure; D005060:Europe; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D012107:Research Design; D016896:Treatment Outcome