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Transcatheter closure of perimembranous ventricular septal defects with the Amplatzer Vascular Plug-II

Published online by Cambridge University Press:  26 October 2015

Nancy Hua ,
Paolo Aquino  and
Carl Y. Owada
Nancy Hua
Affiliation:
UCSF Fresno Pediatric Residency Program, Fresno, California, United States of America
Paolo Aquino
Affiliation:
Department of Cardiology and Cardiothoracic Surgery, Valley Children’s Hospital, Madera, California, United States of America
Carl Y. Owada*
Affiliation:
Department of Cardiology and Cardiothoracic Surgery, Valley Children’s Hospital, Madera, California, United States of America
*
Correspondence to: Dr C. Y. Owada, MD, Department of Cardiology and Cardiothoracic Surgery, FE-14, Valley Children’s Hospital, 9300 Valley Children’s Place, Madera, CA 93636, United States of America. Tel: (559) 353-5476; Fax: (559) 353-8356; E-mail: cowada@childrenscentralcal.org
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Abstract

Objective

The aim of this study was to evaluate the safety and efficacy of the Amplatzer Vascular Plug-II used for the closure of perimembranous ventricular septal defects.

Background

There are no FDA-approved transcatheter devices for the closure of perimembranous ventricular septal defects. Several studies have reported on the use of various devices either off-label or under clinical trial protocols. However these reports have described significant adverse events including residual shunts, complete heart block, arrhythmia, and new valve regurgitations. Thus far, no study on the Amplatzer Vascular Plug-II has been reported.

Methods

We conducted a 4-year retrospective chart review from August, 2010 to August, 2014, of patients with perimembranous ventricular septal defects associated with ventricular septal aneurysm who underwent transcatheter closure using the Amplatzer Vascular Plug-II.

Results

A total of 16 patients underwent Amplatzer Vascular Plug-II transcatheter closure of their perimembranous ventricular septal defects. The median age was 2.56 years (range: 0.5–27.3). Their median weight was 13.0 kg (range: 6.9–71.6). The left ventricular median defect size was 9.3 mm (range: 5.9–14.4). The right ventricular median defect size was 3.6 mm (range: 2.3–5.8). All the patients underwent successful device implantation with 83% of the patients having complete echocardiographic closure at the 1-year follow-up; however, one procedure was complicated by early device embolisation. The device was successfully retrieved and replaced with a larger device. There were no device-related outflow tract obstructions, rhythm abnormalities, or haemolysis.

Conclusion

Application of the Amplatzer Vascular Plug-II for closure of perimembranous ventricular septal defects appears to be a safe and effective treatment option. Prospective clinical trials and longer follow-up periods are warranted.

Keywords

Paediatric interventionstranscatheter device closurecongenital heart disease
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1194 - 1201
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Copyright
© Cambridge University Press 2015 

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