Page 41 - Journal of Structural Heart Disease Volume 2, Issue 1

Original Research Article
Journal of Structural Heart Disease, February 2016, Volume 2, Issue 1: 35-41
DOI: http://dx.doi.org/10.12945/j.jshd.2015.005.14
Received: October 2, 2014 Accepted: January 15, 2015 Published online: February 2016
Low Incidence of Rhythm Disturbance Following Percutaneous Closure of Ventricular Septal Defects Using the Amplatzer Device at Immediate-to-Long-Term Follow Up
Muhammad Dilawar, MD1*, Muhammed Riyas K Rahmath, MD2, Assad Al-Hroob, MD3, Howaida G. El-Said, MD4, Amal El Sisi, MD5, Salwa Morcos, MD6, Mohammed Numan, MD7
1 Division of Pediatric Cardiology, Hamad General Hospital, Doha, Qatar
2 Division of Pediatric Cardiac Surgery, Hamad General Hospital, Doha, Qatar
3 University of Texas, Health Science Center, San Antonio, Texas, USA
4 Division of Cardiology, Rady Children’s Hospital, University of California, San Diego, USA 5 Cairo University Pediatric Hospital, Cairo, Egypt
6 Division of Pediatric Cardiology, Rush University Hospital, Chicago, USA
7 Division of Pediatric Cardiology, University of Texas, Houston, Texas, USA
Abstract
Background: There have been concerns of heart block and rhythm disturbances following transcatheter clo- sure of VSD. Our aim in this study is to evaluate rhythm and conduction disturbances following percutaneous device closure of ventricular septal defects at immedi- ate and long-term follow up.
Methods: A retrospective review of all patients who un- derwent transcatheter VSD closure using an Amplatzer device from January 2003 to September 2012 at Ha- mad General Hospital in Qatar was performed, includ- ing catheterization data, echocardiograms, and EKGs at latest follow up.
Results: Of 49 patients, 45 (35 perimembranous and 10 muscular) were successfully closed. Median age was 8.5 years and median weight was 24 kg. The median VSD size was 6 mm. Median pulmonary to systemic blood ow was 1.4:1, and the median Amplatzer device size was 8 mm. There was no immediate or late mortality, and the closure rate was 91.8%, whereas the procedure was unsuccessful or abandoned in 8.2% of cases. At a mean follow up of 54.5 months, echocardiography
revealed complete ventricular septal defect closure in 41 (91%) patients, and 4 (9%) patients had a small residual shunt. An electrocardiography median follow up of 61.9 months revealed normal sinus rhythm in 37 (84%) cases, incomplete right bundle branch block in 1 (2%) case, complete right bundle branch block in 4 (8%) cases, and left bundle branch block in 2 (4%) study group cases. However, complete atrioventricular block was observed in one (2.9%) of the perimembra- nous VSD patients.
Conclusions: Transcatheter closure of perimembranous and muscular ventricular septal defects is a safe and e ective procedure. Rhythm disturbance at late follow up is comparable with surgical closure rhythm distur- bances and is less frequent than previously found in some transcatheter closure reports.
Copyright © 2016 Science International Corp.
Key Words
Congenital heart defects • Perimembranous VSD • Muscular VSD • Complete atrioventricular block • VSD device closure • Amplatzer VSD device
*Corresponding Author:
Muhammad Dilawar, MD
Pediatric Cardiology
Hamad General Hospital & Weill Cornell Medical College at Qatar PO Box 3050, Doha,Qatar
Tel.: +00974 55916554, Fax: +00974 44391622, E-Mail: dilawarmd@yahoo.com
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2016 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004
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