Original Scientific Articles
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Journal of Structural Heart Disease, February 2016, Volume 2, Issue 1:35-41
DOI: 10.12945/j.jshd.2016.005.14
Low Incidence of Rhythm Disturbance following Percutaneous Closure of Ventricular Septal Defects using the Amplatzer Device at Immediate-to-Long-Term Follow Up
Muhammad Dilawar1, Muhammed Riyas K. Rahmath2, Assad Al-Hroob3, Howaida G El-Said4, Amal El Sisi5, Salwa Morcos6, Mohammed Numan7
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 closure of VSD. Our aim in this study is to evaluate rhythm and conduction disturbances following percutaneous device closure of ventricular septal defects at immediate and long-term follow up.
Methods: A retrospective review of all patients who underwent transcatheter VSD closure using an Amplatzer device from January 2003 to September 2012 at Hamad General Hospital in Qatar was performed, including 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 flow 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 perimembranous VSD patients.
Conclusions: Transcatheter closure of perimembranous and muscular ventricular septal defects is a safe and effective procedure. Rhythm disturbance at late follow up is comparable with surgical closure rhythm disturbances and is less frequent than previously found in some previous transcatheter reports.
Cite this article as: Dilawar M, Rahmath MRK, Al-Hroob A, El-Said HG, Sisi AE, Morcos S, Numan M. Low Incidence of Rhythm Disturbance following Percutaneous Closure of Ventricular Septal Defects using the Amplatzer Device at Immediate-to-Long-Term Follow Up. Structural Heart Disease 2016;2(1):35-41. DOI: 10.12945/j.jshd.2016.005.14
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Original Scientific Articles
Journal of Structural Heart Disease, February 2016, Volume 2, Issue 1:35-41
DOI: 10.12945/j.jshd.2016.005.14
Low Incidence of Rhythm Disturbance following Percutaneous Closure of Ventricular Septal Defects using the Amplatzer Device at Immediate-to-Long-Term Follow Up
Muhammad Dilawar1, Muhammed Riyas K. Rahmath2, Assad Al-Hroob3, Howaida G El-Said4, Amal El Sisi5, Salwa Morcos6, Mohammed Numan7
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 closure of VSD. Our aim in this study is to evaluate rhythm and conduction disturbances following percutaneous device closure of ventricular septal defects at immediate and long-term follow up.
Methods: A retrospective review of all patients who underwent transcatheter VSD closure using an Amplatzer device from January 2003 to September 2012 at Hamad General Hospital in Qatar was performed, including 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 flow 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 perimembranous VSD patients.
Conclusions: Transcatheter closure of perimembranous and muscular ventricular septal defects is a safe and effective procedure. Rhythm disturbance at late follow up is comparable with surgical closure rhythm disturbances and is less frequent than previously found in some previous transcatheter reports.
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Cite this article as: Dilawar M, Rahmath MRK, Al-Hroob A, El-Said HG, Sisi AE, Morcos S, Numan M. Low Incidence of Rhythm Disturbance following Percutaneous Closure of Ventricular Septal Defects using the Amplatzer Device at Immediate-to-Long-Term Follow Up. Structural Heart Disease 2016;2(1):35-41. DOI: 10.12945/j.jshd.2016.005.14
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