Objectives: To review our experience of percutaneous transcatheter closure of VSD using Amplatzer membranous (AMembVSDO) or muscular (AMuscVSDO) VSD Occluders.
Background: Since the advent of specifically designed devices, transcatheter closure of ventricular septal defects (VSD) is an attractive alternative to surgical closure in selected patients.
Methods: Between 10/2002 and 10/2007, transcatheter VSD closure was attempted in 34 patients with either AMembVSDO (27) or AMuscVSDO (7). Median age was 8 years (range 0.6-34) and median weight was 25.4 kg (range 8.1-77.0). The mean length of device follow-up was 35 months (range 8– 59).
Results: Devices were successfully placed in all but three patients who are excluded from all further analysis. Mean fluoroscopy time of 41 min (range 15-107) and mean total procedure time of 181 min (range 100-330) include time spent on other unrelated interventions (n=3). Median device size was 8 mm (range 4-18). Complete closure rate was 61.3% within 1 week, 80.6% within 2 months and 87.1 % at last follow-up. For AMembVSDO the respective rates were 64%, 88% and 92% and for AMuscVSDO 57.1%, 57.1% and 71.4%. No deaths or long term morbidity could be attributed to device implantation. Complications included: transient intra-procedural complete heart block (n=1) and SVT (n=1), transient RBBB(n=3), new trivial aortic regurgitation (n=2), new or increased trivial tricuspid regurgitation (n=4), femoral artery pseudoaneurysm (n=1), brachial plexopathy (n=1) and pyrexia of unknown origin (n=1).
Conclusion: Transcatheter VSD closure using AMembVSDO and AMuscVSDO appears to be a safe and effective alternative to open heart surgery.