title: Transcatheter device closure of postmyocardial infarction ventricular septal defect.
abstract: BACKGROUND
  Transcatheter device closure of postmyocardial infarction ventricular septal defect (PMIVSD) is less invasive than surgical repair. However, its feasibility, timing, outcome, and prognostic factors remain unclear.
  
  
  METHODS
  This was a multicenter, retrospective cohort study. Between February 2012 and July 2015, a total of 10 (8 male and 2 female) patients with PMIVSD undergoing attempted device closure were enrolled retrospectively. The procedures were performed under general anesthesia with fluoroscopic and transesophageal echocardiographic guidance.
  
  
  RESULTS
  The patients enrolled in the study were in the age range 50-85 years (median age of 76.5 years). The interval from infarction to device closure ranged from 6-147 days, with the median of 12 days. A total of 13 devices were implanted in 10 patients. There were five Amplatzer muscular ventricular septal defect occluders, four Amplatzer septal occluders, three Amplatzer PMIVSD occluders and one Amplatzer vascular plug II. Complications included transient ventricular tachycardia in three patients, device embolization in one patient, and tracheal bleeding in one patient. No procedure-related death, stroke, or cardiac tamponade was noted. During follow-up, two patients died of heart failure and two patients died of sepsis. Overall, subjects with age ≥ 80 years, systolic blood pressure ≤ 90 mmHg, and procedure time ≥180 minutes were significant predictor factors for mortality. All patients with the interval of infarction to device closure >12 days survived.
  
  
  CONCLUSIONS
  Our findings indicate that transcatheter device closure of PMIVSD is technically feasible, safe, and effective to reduce the shunt. The crucial prognostic factors were ascertained to be age ≥ 80 years, systolic blood pressure ≤ 90 mmHg, and procedure time ≥180 minutes.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Nie
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Life Science, Tunghai University, Taichung, Taiwan, ROC.
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Lin
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Changhua Christian Hospital, Changhua, Taiwan, ROC.
authors.forename: Ching-Pei
authors.initials: CP
authors.lastname: Chen
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Chia-Hsun
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Tsung-Cheng
authors.initials: TC
authors.lastname: Shyu
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Yeak-Wun
authors.initials: YW
authors.lastname: Quek
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Sheng-Ling
authors.initials: SL
authors.lastname: Jan
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: yunchingfu@gmail.com.
authors.forename: Yun-Ching
authors.initials: YC
authors.lastname: Fu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies
keywords: acute myocardial infarction; cardiac catheterization; transcatheter closure; ventricular septal defect