Transcatheter closure of perimembranous ventricular septal defects using homemade nitionol asymmetric two-disk device / 介入放射学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of transcatheter closure of perimembranous ventricular septal defects (VSD) using home-made nitinol asymmetric two-disk occluder.Methods Trans-catheter closure was attempted in 16 patients with perimembranous ventricular septal defect at a mean age of (16.8 ?11.2) years (range from 5 to 37 years). All patients were diagnosed by the physical examination, echocardiography and left ventriculography. The mean VSD narrowest diameter was (4.31 ?1.35)mm (range from 3 to 8mm) by echocardiography. A 6—8F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein approach. Left ventriculography and transthoracic echocardiography were repeated to assess the efficacy of the closure, 15min after the procedure. Results The mean VSD narrowest diameter was (4.63 ?1.59)mm (range from 3 to 8 mm) measured by left ventriculography. The distance of upper rim of VSD to aortic valve was 1? ?.6 ( 3.31 ?1.9) mm. The devices were successfully deployed in all patients. The diameter of occluder was (6.19 ?1.91)mm (range from 4 to 10mm). There were a trivial residual shunt in 2 patients by left ventriculography and the transthoracic echocardiography after the procedure. No shunt was found by the transthoracic echocardiography 1 week after the procedure. No complication occurred in all patients. Conclusion Transcatheter closure of membranous VSD with home made nitionol asymmetric two-disk occluder is safe and effective. The long-term efficacy is still to be determined by follow-up.