The trascatheter closure of intracristal and subpulmonary ventricular septal defect / 介入放射学杂志

ABSTRACT

Objective To assess the efficacy and safety of transcatheter closure of intracristal ventricular septal defect (IVSD) and subpulmonary ventricular septal defect (SVSD) with home-made eccentric nitinol occluder.Methods Transcatheter closure was attempted in 28 patients (15 men and 13 women), with IVSD (n=22) and SVSD (n=6) at an average of 12.44 ?5.86 years (ranged from 3 to 34 years of age). The homemade device consists of two low profile disks made of Nitinol wire mesh with a 2 mm connecting waist. The left disk is 6 mm towards the apex and 0 mm towards the aortic valve. The right disk is 4 mm larger than the diameter of the waist. The devices were depolyed via the femoral vein using 7-10 Fr sheaths under the guidance of transthoracic echocardiography and fluoroscopy. Results The VSD average diameter was 4.54 ?1.93mm (ranged 2 to 12 mm) with the distance of VSD to aortic valve averaging 0.35 ?0.45mm (range 0 to 1 mm) and the connecting waist diameter of device of 7.65 ?3.11 mm (ranged 4 to 14 mm). The device was implanted successfully in 26 of 28 procedures. A trivial aortic regurgitation occurred in 1 patient with SVSD after deployment of the occluder. Implantation was unsuccessful in 2 patients with SVSD having large septal defects. No other complications were observed. The mean fluoroscopy time for the procedure was 14.07 ?5.19 min (range 9 to 40 min) and the whole procedure time was 59.81 ?17.76min(range 40 to 150 min).Conclusions Transcatheter closure of IVSD and SVSD with homemade eccentric nitinol occluder is effective, easy and safe. Longer term follow-up is necessary for assessing the efficacy.