Page 17 - Journal of Structural Heart Disease Volume 5, Issue 6

241 Original Scientific Article
Figure 3. Perimembranous VSD. Panel A. TEE 120 degrees view. The arrows show the VSD. Panel B. TEE 120 degrees with Doppler color where the arrow shows the flow of the color through the VSD. Panel C. Left Ventricular Angiography (4 chambers): the arrow shows the VSD. Panel D. Retrograde approach positioning of the device. Panel E. Left Ventricle Angiography (4 chambers): the arrow shows the correct position of the device. Panel F. TEE 120 degrees view that shows the trivial residual shunt.
the right orifice of the defect. The left disk has a main role in the perimembranous and high muscular VSDs, due to the risk of AV block. In the case of perimembra- nous VSD with more than one right orifice, the device will need to be placed inside the aneurysm to avoid the conducting system and to occlude all the right orifices. This is achieved with a retrograde approach (Figure 3).
In muscular VSDs, the device has to inevitably lay over the interventricular septum; special care has to be taken in high muscular VSDs due to the direct rela- tionship with the conduct system (Figure 4).
Follow up
• 24 hs: Thoracic X-Ray, EKG and TTE.
• 1 month: EKG and TTE.
• 3 months: EKG, TTE, and 24hs Holter.
• 6 months: EKG and TTE.
• 1 year: Thoracic X-Ray, EKG, TTE and 24hs Holter.
Statistics Analysis
T-Test or Student Test was used in the statistical analysis. Statistical significance is p <0.05.
Results
17 procedures performed on 17 patients: 14 pa- tients > 10 kg and 3 patients <5 kg.
> 10 kg
Sex: 9 males, 5 females; Age: median 12.67 years (1.11 to 37 years); and Weight: mean 39,96 kg ±SD (12 to 89 kg).
2 patients had complete right bundle branch block prior to the procedure, both postoperative.
VSD type
• Perimembranous VSD with aneurysm: 4 patients. 2 of them had 2 right orifices.
Damsky Barbosa J. et al.
VSD Closure with KONAR-MFO