Journal of Structural Heart Disease, October 2019, Volume 5, Issue 5:221-228
Transcatheter Trans-aortic Retrograde Approach for the Closure of Perimembranous Ventricular Septal Defects using Cocoon [Amplatzer Duct Cccluder I Like] Device – An Initial Experience from a Single Centre
Department of Cardiology, Maxcure-Mediciti Hospitals, Hyderabad, Telangana, India
Aims & Objective: Transcatheter ventricular septal defect (VSD) device closure is usually performed using the antegrade approach [1–3]. A few case series of a retrograde technique using the Amplatzer duct occluder (ADO) II device have been reported [4, 5]. We aimed to assess the feasibility and safety of a retrograde closure technique using an ADO I like device, which is used for the closure of patent ductus arteriosus (PDA).
Methods: Between June 2015 and January 2018, eight consecutive, consenting cases with congenital perimembranous VSDs underwent trans-aortic device closure using an ADO I like device in a single tertiary care center.
Results: The median age was 17.1 years (5-32, SD 17.125 years) with 3 males and 5 females. Mean defect size was 6.6 mm (4.5 - 8.6 mm, SD 6.6125), with a median aortic rim of 3.4 mm (2-5, SD 3.4125). Median Qp/Qs and right ventricular systolic pressure was 1.8 (1.6-2.1, SD 1.825) and 41.3 mm Hg (33-50, SD 41.25) respectively. Median fluoroscopy and procedure times were 13.3 (10.6-15.7, SD 13.275) and 23.5 (18.2-27.2, SD 22.722) minutes respectively. The defects were successfully closed with no residual shunt in all 8 patients (100%). There was no semilunar or atrioventricular valve leaflet entrapment or regurgitation. There were no instances of acute device dislodgement or Atrioventricular (AV) block. Over a median follow up of 18 months, all eight patients remained symptom-free with no residual shunt or late complications.
Conclusion: In this initial experience, trans-aortic, retrograde VSD device closure using an ADO I like device appears feasible and safe in patients with perimembranous VSDs which a cost-effective alternative to routine use of the ADO II device.
Cite this article as: Jariwala P, Narayanan K, Kumar EAP. Transcatheter Trans-aortic Retrograde Approach for the Closure of Perimembranous Ventricular Septal Defects using Cocoon [Amplatzer Duct Cccluder I Like] Device – An Initial Experience from a Single Centre. Structural Heart Disease 2019;5(5):221-228. DOI: 10.12945/j.jshd.2019.002.19
You must be registered and logged in to leave comments.
There have been no comments posted yet
All comments will be screened and reviewed before posting. Statements, opinions, and results of studies published in Journal of Structural Heart Disease are those of the authors and do not reflect the policy or position of The Journal and Science International and the Editorial Board and provides no warranty as to their accuracy or reliability. Material is copyrighted and owned by Science International and cannot be used without expressed permission.