Page 15 - Journal of Structural Heart Disease Volume 2, Issue 5

Original Research Article
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minimal distortion of the aortic root in a smaller child. The occlusive nature of the device has been well reported in high ow defects such as VSDs and patent ductus arteriosus [10, 11].
The learning point from the case was to ensure full interrogation of the ventricular septum prior to closure. A small perimembranous VSD may be easily overlooked, especially considering the turbulence seen on color imaging from the right sinus of Valsalva throughout the cardiac cycle. The perimembranous region of the septum is separated from the aortic root only by the thin lea ets of the aortic valve. In retrospect, knowledge of this defect would not have changed our approach. It is arguable that the VSD may have been contributing to the mild AR; however, AR has been reported in up to 71% of patients with ruptured sinus of Valsalva aneurysms [2], which is far greater than seen with a small perimembranous VSD. It is arguable that the device may provide some support to the right sinus and consequently to the support structure of the right coronary cusp to mitigate against further AR.
We elected to use low-dose aspirin following device implantation to limit the risk of thromboembolism. The evidence for such an approach is not strong; however, it has been a widely prescribed practice with device closure where the left-sided discs are proximal to the cerebral circulation origin.
Conclusions
In conclusion, ruptured sinus of Valsalva aneurysms are exceedingly rare in children, but transcatheter closure is feasible, and the ADO II may be an attractive device choice to minimize aortic root distortion.
Con ict of Interest
The authors have no con ict of interest relevant to this publication.
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Journal of Structural Heart Disease, October 2016
Volume 2, Issue 5:213-216
Cite this article as: Kenny D, Gomez N, Ramirez J. Transcatheter Closure of a Ruptured Sinus of Valsalva Aneurysm with the Amplatzer Ductal Occluder II in a 6-Year-Old Girl. Structural Heart Disease. 2016;2(5):213-216. DOI: http:// dx.doi.org/10.12945/j.jshd.2016.008.15