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Procedural and short-term outcomes of transcatheter closure of ventricular septal defect using lifetech multifunctional occluder: initial experience

Published online by Cambridge University Press:  09 December 2020

Judah D. Gozar Open the ORCID record for Judah D. Gozar [Opens in a new window] ,
Dexter E. D. Cheng  and
Jose J. D. Del Rosario
Judah D. Gozar*
Affiliation:
Philippine General Hospital, Pediatrics, Taft Avenue, Metro Manila1000, Philippines
Dexter E. D. Cheng
Affiliation:
Philippine General Hospital, Pediatrics, Taft Avenue, Metro Manila1000, Philippines
Jose J. D. Del Rosario
Affiliation:
Philippine General Hospital, Pediatrics, Taft Avenue, Metro Manila1000, Philippines
*
Author for correspondence: Judah Gozar, Philippine General Hospital, Pediatrics, Taft Avenue, Metro Manila 1000, Philippines. Tel: +63-9173100955. E-mail: drjudahtinagozar@gmail.com
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Abstract

The Lifetech Multifunctional occluder is a versatile device with an improved delivery and flexibility that reduces the risk of atrioventricular block. This is a retrospective, descriptive, pilot study done in 25 patients who underwent transcatheter closure of ventricular septal defect using Lifetech Multifunctional occluder from February 2017 to January 2018.

The average age was 9.32 ± 7.20 years, with a range from 1 to 32 years. Procedural success was 100% with no case needing a change of device size. Closure rate on follow up was at 42% (10/24), 52% (12/23), and 81% (17/21) at 1 day, 1 month, and 6 months, respectively. At 6-month follow up, pre-procedure tricuspid regurgitation disappeared by 38%. However, the incidence of new onset tricuspid regurgitation to trace was 16% (2) and mild 8% (1). Pre-procedure mild aortic regurgitation remained the same status throughout the 6-month follow up. Closure of the defect did not improve or worsen the aortic regurgitation. Post-transcatheter closure of ventricular septal defect with mild infundibular hypertrophy, the 1-year-old patient had resolution of the infundibular hypertrophy after 6 months but our 9-year-old patient had persistence of the mild infundibular hypertrophy even after 6 months. One patient (4%) developed transient widened QRS complexes post-transcatheter closure that resolved after 1 month. In total, 92% of the patients had no periprocedural complications. While one patient each had an inadvertent urinary bladder puncture and device embolisation.

Our retrospective review of the procedural and short-term outcomes of transcatheter closure of ventricular septal defect sizes 2–10 mm, using the Lifetech Multifunctional occluder, appears to be safe and effective. However, long-term follow up is warranted.

Keywords

Ventricular septal defecttranscatheter closurelifetech multifunctional occludergerbode defectinfundibular hypertrophy
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 3 , March 2021 , pp. 435 - 445
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Penny, DJ, Vick, GW. Ventricular septal defect. Lancet 2011; 377: 1103–1112.CrossRefGoogle ScholarPubMed
Hoffman, JI, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
Perrault, H, Drblik, SP, Montigny, M, et al. Comparison of cardiovascular adjustments to exercise in adolescents 8 to 15 years of age after correction of tetralogy of Fallot, ventricular septal defect or atrial septal defect. Am J Cardiol 1989; 64: 213–217.CrossRefGoogle ScholarPubMed
Klitsie, LM, Kuipers, IM, Roest, AAW, et al. Disparity in right vs. left ventricular recovery during follow-up after ventricular septal defect correction in children. Eur J Cardiothorac Surg 2013; 44: 269–274.CrossRefGoogle ScholarPubMed
Meijboom, F, Szatmari, A, Utens, E, et al. Long-term follow-up after surgical closure of ventricular septal defect in infancy and childhood. J Am Coll Cardiol 1994; 24: 1358–1364.CrossRefGoogle ScholarPubMed
Jacobs, JP, O’Brien, SM, Pasquali, SK, et al. Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons Congenital Heart surgery database. Ann Thorac Surg 2011; 92: 2184–2191; discussion 91–92.CrossRefGoogle Scholar
Andersen, HØ, deLeval, MR, Tsang, VT, Elliott, MJ, Anderson, RH, Cook, AC Is complete heart block after surgical closure of ventricular septum defects still an issue? Ann Thorac Surg 2006; 82: 948–956.CrossRefGoogle ScholarPubMed
Tucker, EM, Pyles, LA, Bass, JL, Moller, JH Permanent pacemaker for atrioventricular conduction block after operative repair of perimembranous ventricular septal defect. J Am Coll Cardiol 2007; 50: 1196–1200.CrossRefGoogle ScholarPubMed
Roos-Hesselink, JW, Meijboom, FJ, Spitaels, SEC, et al. Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22–34 years. Eur Heart J 2004; 25: 1057–1062.CrossRefGoogle ScholarPubMed
Yang, J, Yang, L, Yu, S, et al. Transcatheter versus surgical closure of perimembranous ventricular septal defects in children: a randomized controlled trial. J Am Coll Cardiol 2014; 63: 1159–1168.CrossRefGoogle ScholarPubMed
Butera, G, Carminati, M, Chessa, M, Piazza, L, Micheletti, A, Negura, DG, et al. Transcatheter closure of perimembranous ventricular septal defects: early and long-term results. J Am Coll Cardiol 2007; 50: 1189–1195.CrossRefGoogle ScholarPubMed
Walsh, MA, Bialkowski, J, Szkutnik, M, Pawelec-Wojtalik, M, Bobkowski, W, Walsh, KP. Atrioventricular block after transcatheter closure of perimembranous ventricular septal defects. Heart 2006; 92: 1295–1297.CrossRefGoogle ScholarPubMed
Carminati, M, Butera, G, Chessa, M, et al. Transcatheter closure of congenital ventricular septal defects: results of the European registry. Eur Heart J 2007; 28: 2361–2368.CrossRefGoogle ScholarPubMed
Chessa, M, Carminati, M, Cao, QL, et al. Transcatheter closure of con- genital and acquired muscular ventricular septal defects using the Amplatzer device. J Invasive Cardiol 2002; 14: 322–327.Google Scholar
Chungsomprasong, P, Durongpisitkul, K, Vijarnsorn, C, Soongswang, J, Lê, TP. The results of transcatheter closure of VSD using Amplatzer® device and Nit Occlud® Lê coil. Catheter Cardiovasc Interv 2011; 78: 1032–1040.CrossRefGoogle ScholarPubMed
Yang, R, Kong, XQ, Sheng, YH, et al. Risk factors and outcomes of post-procedure heart blocks after transcatheter device closure of perimembranous ventricular septal defect. J Am Coll Cardiol Cardiovasc Interv 2012; 5: 422–427.CrossRefGoogle ScholarPubMed
Zhou, D, Pan, W, Guan, L, Ge, J Transcatheter closure of perimembranous and intracristal ventricular septal defects with the SHSMA occluder. Catheter Cardiovasc Interv 2012; 79: 666–674.CrossRefGoogle ScholarPubMed
Koneti, NR. LifeTech Scientific Corporation Attends CSI Asia Pacific 2017. 2017 March 2. http://www.lifetechmed.com/en/news/n1/20170316/1797.aspx Google Scholar
Holzer, R, Balzer, D, Cao, QL, Lock, K, Hijazi, ZM. Amplatzer muscular ventricular septal defect investigators. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occlude: immediate and mid-term results of a U.S. registry. J Am Coll Cardiol 2004; 43: 1257–1263.CrossRefGoogle Scholar
Riemenschneider, TA, Moss, AJ. Left ventricular-right atrialcommunication. Am J Cardiol 1967; 19: 710–718.CrossRefGoogle Scholar
Lifetech Product Cera VSD occluder. http://www.lifetechmed.com/en/product/p1/cera/282.aspx Google Scholar
Carminati, M, Butera, G, Chessa, M, et al. Transcatheter closure of congenital ventricular septal defects: results of the European registry. Eur Heart J 2007; 28: 2361–2368.CrossRefGoogle ScholarPubMed
Mahesh, SK, Kumar, S, Satheesh, S, Jayaraman, B. Real time three-dimensional transesophageal echocardiography demonstration of membranous septal aneurysm causing severe right ventricular outflow tract obstruction. Echocardiography 2015; 32: 184–186.CrossRefGoogle ScholarPubMed