title: New design of the Amplatzer membranous VSD occluder: a step forward?
abstract: Closure of perimembranous ventricular septal defects (PmVSDs) [4] with the original Amplatzer membranous VSD occluder (mVSD1) has been associated with an increased risk of complications, the most notable of which has been complete heart block. This has led to the introduction of a new device to close PmVSDs. The authors describe their experience with the new Amplatzer membranous VSD occluder (mVSD2) in two patients and critique the new device design and delivery system, comparing it with the mVSD1 occluder. Two patients underwent attempted closure of PmVSDs with the new mVSD2 device. One patient had successful closure of the defect with no residual shunt and no evidence of heart block at follow-up evaluation. Trace to mild aortic insufficiency was observed at the time of closure and at the last follow-up visit. The rhythm remained sinus. In the second patient, the device was placed but removed before release because of inability to orient the device in optimal position. Percutaneous closure of PmVSD is feasible with the new mVSD2 occluder. The change in the design may reduce the incidence of complete heart block. It remains to be seen whether the device will be suitable for smaller patients.
authors: Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, 1653 West Congress Parkway, Jones 770, Chicago, IL, 60612, USA.
authors: Kiran
authors: K
authors: Mallula
authors: Najma
authors: N
authors: Patel
authors: Zahid
authors: Z
authors: Amin
mesh_terms: D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D018618:Echocardiography, Doppler, Color; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011474:Prosthesis Design; D055989:Septal Occluder Device
references: J Cardiovasc Med (Hagerstown). 2007 Jan;8(1):39-45
references: 17255815
references: Catheter Cardiovasc Interv. 2012 Jun 1;79(7):1153-60
references: 22162409
references: J Thorac Cardiovasc Surg. 2008 Nov;136(5):1223-8
references: 19026807
references: J Am Coll Cardiol. 2006 Jan 17;47(2):319-25
references: 16412854
references: Catheter Cardiovasc Interv. 2011 Jan 1;77(1):91
references: 21181972
references: Pediatr Cardiol. 2005 May-Jun;26(3):216-9
references: 16082578
references: Catheter Cardiovasc Interv. 2013 Sep 1;82(3):474-9
references: 22431366
references: Eur Heart J. 2007 Oct;28(19):2361-8
references: 17684082