[A monocenter experience of ventricular septal defects treated by catherization].
BACKGROUND
Studies on ventricular septal defects closure by catheterization confirm its feasibility without reporting clearly the indications and difficulties encountered.


RESULTS
From 2001 to end-2006, 22 patients benefited from 26 ventricular septal defects closure (15 muscular and 7 membranous) at a median age and weight of 2.1 years and 12.5 kg, respectively. A perventricular catheterization was performed in 2 cases. Eighteen patients (82%) benefited from 21 prostheses with success. The closure was associated to surgery in 9 cases (41%) whereas it substituted surgery in the other 13 cases (59%). The median duration of the procedure was significantly longer in case of muscular ventricular septal defects (215 min (175-510) vs. 170 min (120-225), p=0.04). Major complications are reported in 5 cases out of 26 catheterization (19%), including one death related to conduction block, occurring after the implantation of two prostheses in a patient with aortopulmonary transposition. All other associated cardiac diseases have been corrected. A prosthetic emboli occurred in one case, 1.5 months after implantation. It had been retrieved by catheterization. Two patients died afterwards from non-procedure-related causes. After a median follow-up of 1.1 years, the 17 other patients remained asymptomatic. One child with a perimembranous prosthesis presents a paroxystic atrio-ventricular block.


CONCLUSIONS
Even though indispensable for the curative treatment of several congenital cardiac diseases including non-operable ventricular septal defects, this procedure is related to a substantial rate of mortality and morbidity. The risk of atrio-ventricular block must be adequately considered in case of membranous ventricular septal defects.
Paoli
F
F
Cardiologie pédiatrique, Département de cardiologie, Hôpital d'Enfants de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5.
Dragulescu
A
A
Amedro
P
P
Ovaert
C
C
Mas
B
B
Ghez
O
O
Metras
D
D
Kreitmann
B
B
Fraisse
A
A
D000293:Adolescent; D000328:Adult; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004617:Embolism / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000209:etiology; D006330:Heart Defects, Congenital / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome