title: Transcatheter Closure of Intracristal Ventricular Septal Defect With Mild Aortic Cusp Prolapse Using Zero Eccentricity Ventricular Septal Defect Occluder.
abstract: BACKGROUND
  Transcatheter closure is a well-established therapy for patients with perimembranous ventricular septal defects (VSDs), but with limited experience in intracristal VSDs (IVSDs) with aortic cusp prolapse (ACP).
  
  
  RESULTS
  From 2012 to 2014, we reviewed 38 patients with IVSDs complicated with mild ACP who underwent device closure, and, in light of the findings, assessed the effect of transcatheter intervention on preoperative mild ACP. The zero eccentric VSD occluder was chosen for closure (Shanghai Shape Memory Alloy Ltd, Shanghai, China). The mean defect was 4.8±1.6 mm (range, 2-8) as measured by transthoracic echocardiography and the mean device size was 10.1±2.1 mm (range, 4-14). Placement of the device was successful in 35 patients (92.1%). In the remaining 3 patients (7.9%), major complications occurred and they were converted to surgical intervention: severe aortic regurgitation (AR) in 2 patients and occluder dislodgement in 1 patient. During the follow-up (median 14.2 months; range, 3-24), no deaths, residual shunt, late-onset AR, heart block, or device failure occurred.
  
  
  CONCLUSIONS
  The mid-term prognostic results of high success rate and low complications rate in this study are inspiring. Transcatheter closure of IVSD with mild ACP can be performed safely and effectively as an alternative to surgery in selected patients.
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University.
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.forename: Pan
authors.initials: P
authors.lastname: Li
authors.forename: Suxuan
authors.initials: S
authors.lastname: Liu
authors.forename: He
authors.initials: H
authors.lastname: Du
authors.forename: Bili
authors.initials: B
authors.lastname: Zhang
authors.forename: Xiucai
authors.initials: X
authors.lastname: Jin
authors.forename: Xing
authors.initials: X
authors.lastname: Zheng
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Shaoping
authors.initials: S
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.forename: Yongwen
authors.initials: Y
authors.lastname: Qin
authors.forename: Xianxian
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D001023:Aortic Valve Prolapse / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies