title: Transcatheter closure of perimembranous ventricular septal defects (VSD) with VSD occluder: early and mid-term results.
abstract: Results of perimembranous ventricular septal defects (pmVSD) transcatheter closure have been reported in the literature, mostly with the Amplatzer VSD device (muscular or eccentric) (AGA Medical Corp., Golden Valley, MN, USA). However, the data of percutaneous closure of pmVSD with VSD occluder (VSD-O) made in China are still limited. We sought to analyze the safety, efficacy, and follow-up results of percutaneous closure of pmVSD with VSD-O made in China. Seventy-eight patients underwent percutaneous closure of pmVSD at our institution between February 2005 and June 2007. A VSD device made in china (Huayishengjie Medical Corp., Beijing, China) was used in all subjects. The mean age at closure was 11 years (range 2.5-44 years). The attempt to place the device was successful in 74 patients (94.9%). The median device size used was 8 mm (range 5-16 mm). No deaths occurred. Total occlusion rate was 62.8% at completion of the procedure, rising to 87.2% at discharge and 99% during the follow-up. A total of eight early complications occurred (10.3%), but in all subjects these were transient. The median follow-up was 32 months. The most significant complication was complete atrioventricular block (cAVB) in the early phase (five subjects, 6.4%) and during the follow-up (one subject, 1.3%), and there was no need for pacemaker implantation in six subjects. Logistic regression analysis showed that the only variable significantly associated with the occurrence of this complication was age at the time of the procedure (p = 0.025; OR 0.22). All subjects experiencing this problem were <5 years old. Percutaneous pmVSD closure used VSD-O made in China is associated with excellent success and closure rates, no mortality, and low morbidity. Nowadays, pmVSD percutaneous closure is a valuable alternative to surgery. Longer follow-up data and improvements in device characteristics are needed to reduce the risk of cAVB.
authors: Department of Cardiology, Shanghai Tenth People's Hospital of Tongji University, 301 Yanchang Road, Shanghai 200072, China. weiyidong@yahoo.com
authors: Yidong
authors: Y
authors: Wei
authors: Xian
authors: X
authors: Wang
authors: Shouyan
authors: S
authors: Zhang
authors: Lei
authors: L
authors: Hou
authors: Yong
authors: Y
authors: Wang
authors: Yawei
authors: Y
authors: Xu
authors: Qi
authors: Q
authors: Sun
authors: Huaibing
authors: H
authors: Zhao
references: Heart. 2003 Aug;89(8):918-22
references: 12860872
references: Circulation. 1993 Feb;87(2 Suppl):I38-51
references: 8425321
references: J Interv Cardiol. 2003 Feb;16(1):83-91
references: 12664821
references: J Am Coll Cardiol. 2007 Sep 18;50(12):1189-95
references: 17868812
references: Catheter Cardiovasc Interv. 2004 Mar;61(3):403-10
references: 14988905
references: J Am Coll Cardiol. 2006 Jan 17;47(2):319-25
references: 16412854
references: Catheter Cardiovasc Interv. 2003 Sep;60(1):107-14
references: 12929113
references: Pediatr Cardiol. 2005 May-Jun;26(3):216-9
references: 16082578
references: Catheter Cardiovasc Interv. 2006 Oct;68(4):620-8
references: 16969878
references: Heart. 2006 Sep;92(9):1295-7
references: 16449504
references: J Am Coll Cardiol. 2004 Aug 4;44(3):513-9
references: 15358013
references: Heart Vessels. 2009 Nov;24(6):440-5
references: 20108077
references: Catheter Cardiovasc Interv. 2002 Aug;56(4):508-15
references: 12124963
references: Heart Vessels. 2008 May;23(3):187-92
references: 18484162
references: Catheter Cardiovasc Interv. 2005 Nov;66(3):436-41
references: 16216027
references: J Am Coll Cardiol. 2002 Mar 20;39(6):1061-5
references: 11897451
references: Am J Cardiol. 2005 Dec 19;96(12A):52L-58L
references: 16399093
references: Catheter Cardiovasc Interv. 2006 Jul;68(1):145-52
references: 16763998
references: J Am Coll Cardiol. 2004 Apr 7;43(7):1257-63
references: 15063439
references: Am Heart J. 2006 Jan;151(1):228-34
references: 16368323
references: Catheter Cardiovasc Interv. 2003 Feb;58(2):238-45
references: 12552550