Safety and efficacy of transcatheter closure of outlet-type ventricular septal defects in children and adults with Amplatzer Duct Occluder II
Journal
Journal of the Formosan Medical Association
Journal Volume
120
Journal Issue
1
Pages
180-188
Date Issued
2021
Author(s)
Abstract
Background/purpose: Outlet-type VSD is frequently associated with aortic valve prolapse that surgery is frequently required. The literature regarding outcomes of transcatheter closure of outlet-type VSDs is scant. This study was conducted to know the safety and efficacy of transcatheter closure of outlet-type ventricular septal defects (VSDs) with Amplatzer Duct Occluder II (ADO II). Methods: Medical records of patients underwent attempted transcatheter closure of outlet-type VSD with ADO II between October 2013 and August 2019 were retrospectively reviewed. Results: Among 49 patients, transcatheter closure was successful in 45 (91.8%; 33 males and 12 females; mean [± standard deviation] age and body weight: 15.8 (±17.7) years and 36.6 (±23.3) kg, respectively). The median VSD diameter was 4.0 mm (range: 1.2–6.0 mm). Device closure failed in four because the sheath could not be advanced through a prograde or retrograde route in one patient, occluder embolization in the two patients, and failed right ventricular disc anchoring in one patient. After a mean follow-up of 22.7 months (range: 0.3–51.1 months), only nine (20.0%) patients had increased severity in aortic regurgitation (AR) on the echocardiography. Preprocedural AR decreased in severity or even disappeared in 11 (24.4%) patients. No heart block or device failure occurred during follow-up. A trivial-to-small residual shunt was detected in 19 patients (42.2%) in the most recent echocardiography. Conclusion: Transcatheter closure of outlet-type VSDs with ADO II is feasible. Although no significant aggravation of AR was observed in the short-to-mid-term follow-up, long-term follow-up is mandatory. ? 2020
SDGs
Other Subjects
acetylsalicylic acid; cefazolin; heparin; adult; aortic regurgitation; aortic valve repair; aortography; artery diameter; Article; artificial embolization; ascending aorta; body weight; child; clinical article; clinical evaluation; clinical outcome; conscious sedation; controlled study; data analysis software; device embolization; device failure; device safety; disease severity; echocardiography; female; femoral vein; follow up; general anesthesia; heart catheterization; heart right ventricle failure; heart surgery; heart ventricle septum defect; human; left pulmonary artery; local anesthesia; male; medical record review; middle aged; outlet type ventricular septal defect; pediatric surgery; preschool child; pulmonary artery; retrospective study; school child; superior cava vein; systemic circulation; therapy effect; thorax radiography; transcatheter outlet type ventricular septal defect closure; transesophageal echocardiography; transthoracic echocardiography; vascular access; young adult; adolescent; adverse device effect; diagnostic imaging; heart septum defect; infant; newborn; septal occluder; treatment outcome; Adolescent; Adult; Cardiac Catheterization; Child; Child, Preschool; Female; Heart Septal Defects, Ventricular; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Septal Occluder Device; Treatment Outcome; Young Adult
Publisher
Elsevier B.V.
Type
journal article