| Peer-Reviewed

Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less

Received: 9 December 2022    Accepted: 30 December 2022    Published: 22 May 2023
Views:       Downloads:
Abstract

Aim: This study aims to evaluate feasibility and complications of device closure of ventricular septal defect (VSD) in children weighing 5kg. Methods: Between March 2018 and March 2021, total 15 patients with Ventricular Septal Defect (VSD) weighing 5Kg or less were taken to Cath lab for percutaneous VSD closure out of which 13 (86%) had successful transcatheter closure and 2 (14%) cases were unsuccessful and subsequently send for surgical closure. All of these13 patients under went transcatheter closure of VSD using either a Amplatzer duct occluder1, Amplatzer duct Occluder 2 or Amplatzer Muscular VSD Occluder. A retrospective review of the results and related complications was done. Results: Among these 15 patients, 7 were females, 6 were male and the mean age was 8.5 (4-16month. The mean weight in this study was 4.46Kg (2.3-5Kg). Mean VSD size was 4.5 (3-10mm), 9 patients had VSD sizes between 3to5mm, 3 had between5-10 mm and 1 with more than 10mm. Among types of VSD, 9 cases were having Perimembranous, 1 was upper muscular, 1was mid while 1was lower muscular and only 1 had outlet muscular VSD. Amplatzer Duct Occluder (ADOI) was used in 2 cases, 9 were closed with Amplatzer Duct Occluder (ADO2) and 2 were selected for closure with Amplatzer Muscular VSD Occluder. Transthoracic Echocardiography (TTE) in immediate post intervention period revealed all these devices in situ with no or minimal residual flow which subsided within 24 hours period. As far as complications are concerned, we had one device embolization noted in our study. Tricuspid regurgitation (TR) was noted at the time of discharge in 4 patients but subsided after 48 hours while trivial aortic regurgitation was noted (AR) only in one case which is under close follow up and not increasing in severity after 6 months follow-up. Conclusions: Transcatheter closure of VSD in children 5kg or less is feasible and safe alternative to surgical VSD closure.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 1)
DOI 10.11648/j.ijcts.20230901.12
Page(s) 5-8
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Ventricular Septal Defect, Transcatheter Closure, Weight<5kgs, Interventions

References
[1] Lillehei C. W, Cohen M., Warden H. E., Ziegler N. R, Varco R. L. The results of direct vision closure of ventricular septal defects in eight patients by means of controlled cross circulation, SurgGynecolObstet, 1955; 101: 446–466.
[2] Holzer R, Balzer D, Qi-Ling C, Lock K, Hijazi ZM. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder J Am CollCardiol. 2004; 43 (7) 1257–1263.
[3] ButeraG, Carminati M., Chessa M., PiazzaL, Micheletti A, Negura D. G, Abella R. Giamberti A., Frigiola A. Transcatheter closure of perimembranous ventricular septal defects—early and long-term results, J Am CollCardiol, 2007; 50: 3.
[4] Narin, N., Pamukcu, O., Tuncay, A. et al. Percutaneous Ventricular Septal Defect Closure in Patients Under 1 Year of Age PediatrCardiol. 2018; 39: 1009–15.
[5] Narin N, Baykan A, Pamukcu O et al. ADO II in percutaneous VSD closure in pediatric patients. J IntervCardiol. 2015; 28: 479–484.
[6] Saurav A, Kaushik M, Mahesh Alla V et al. Comparison of percutaneous device closure versus surgical closure of peri-membranous ventricular septal defects: a systematic review and meta-analysis. Catheter CardiovascInterv 2015; 86: 1048–1056.
[7] R. Trehan V, Kumar A, Kalra G. S, Nigam M. Transcatheter closure of congenital ventricular septal defects: experience with various devices, J IntervCardiol 2003; 16: 83–91.
[8] Vijayalakshmi IB1, Narasimhan C, Singh B, et al. Treatment of congenital non ductal shunt lesions with the Amplatzer Duct Occluder II. Catheter CardiovascInterv 2013; doi: 10.1002/ccd.25250.
[9] Tan CA, Levi DS, Moore JW. Percutaneous closure of perimembranous ventricular septal defect associated with a ventricular septal aneurysm using the Amplatzer ductal occluder. Catheter CardiovascInterv 2005; 66 427–431.
[10] Dilawar M, Numan M, El Sisi A, et al. Percutaneous closure of ventricular septal defects associated with tunnel shaped aneursym using Amplatzer duct occluder. PediatrCardiol 2008; 29: 366–370.
[11] Kanaan M, Ewert P, Berger F, et al. Follow up of patients with interventional closure of ventricular septal defects with Amplatzer Duct Occluder II. PediatrCardiol 2015; 36: 379–385.
[12] Santhanam H et al. A meta-analysis of transcatheter device closure of perimembranous ventricular septal defect. International Journal of Cardiology. 2018; 254: 75–83.
[13] Zuo J, Xie J, Yi W, Yang J, Zhang J, Li J, Yi D. Results of transcatheter closure of perimembranous ventricular septal defect. Am J Cardiol. 2010; 106: 1034–1037.
[14] Walavalkar V, Maiya S, Pujar S, Ramachandra P, Siddaiah S, Spronck B, Vanagt WY, Delhaas T. Percutaneous device closure of congenital isolated ventricular septal defects: a single-center retrospective database study amongst 412 cases. Pediatr Cardiol. 2020; 41: 591–598.
[15] Chungsomprasong P, Durongpisitkul K, Vijarnsorn C, Soongswang J, Lê TP. The results of transcatheter closure of VSD using Amplatzer® device and Nit Occlud® Lê coil. Catheter Cardiovasc Interv. 2011; 78: 1032–1040.
Cite This Article
  • APA Style

    Mirza Mohd Kamran, Shaad Abqari, Azam Haseen, Mayank Yadav. (2023). Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less. International Journal of Cardiovascular and Thoracic Surgery, 9(1), 5-8. https://doi.org/10.11648/j.ijcts.20230901.12

    Copy | Download

    ACS Style

    Mirza Mohd Kamran; Shaad Abqari; Azam Haseen; Mayank Yadav. Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(1), 5-8. doi: 10.11648/j.ijcts.20230901.12

    Copy | Download

    AMA Style

    Mirza Mohd Kamran, Shaad Abqari, Azam Haseen, Mayank Yadav. Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less. Int J Cardiovasc Thorac Surg. 2023;9(1):5-8. doi: 10.11648/j.ijcts.20230901.12

    Copy | Download

  • @article{10.11648/j.ijcts.20230901.12,
      author = {Mirza Mohd Kamran and Shaad Abqari and Azam Haseen and Mayank Yadav},
      title = {Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {9},
      number = {1},
      pages = {5-8},
      doi = {10.11648/j.ijcts.20230901.12},
      url = {https://doi.org/10.11648/j.ijcts.20230901.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230901.12},
      abstract = {Aim: This study aims to evaluate feasibility and complications of device closure of ventricular septal defect (VSD) in children weighing 5kg. Methods: Between March 2018 and March 2021, total 15 patients with Ventricular Septal Defect (VSD) weighing 5Kg or less were taken to Cath lab for percutaneous VSD closure out of which 13 (86%) had successful transcatheter closure and 2 (14%) cases were unsuccessful and subsequently send for surgical closure. All of these13 patients under went transcatheter closure of VSD using either a Amplatzer duct occluder1, Amplatzer duct Occluder 2 or Amplatzer Muscular VSD Occluder. A retrospective review of the results and related complications was done. Results: Among these 15 patients, 7 were females, 6 were male and the mean age was 8.5 (4-16month. The mean weight in this study was 4.46Kg (2.3-5Kg). Mean VSD size was 4.5 (3-10mm), 9 patients had VSD sizes between 3to5mm, 3 had between5-10 mm and 1 with more than 10mm. Among types of VSD, 9 cases were having Perimembranous, 1 was upper muscular, 1was mid while 1was lower muscular and only 1 had outlet muscular VSD. Amplatzer Duct Occluder (ADOI) was used in 2 cases, 9 were closed with Amplatzer Duct Occluder (ADO2) and 2 were selected for closure with Amplatzer Muscular VSD Occluder. Transthoracic Echocardiography (TTE) in immediate post intervention period revealed all these devices in situ with no or minimal residual flow which subsided within 24 hours period. As far as complications are concerned, we had one device embolization noted in our study. Tricuspid regurgitation (TR) was noted at the time of discharge in 4 patients but subsided after 48 hours while trivial aortic regurgitation was noted (AR) only in one case which is under close follow up and not increasing in severity after 6 months follow-up. Conclusions: Transcatheter closure of VSD in children 5kg or less is feasible and safe alternative to surgical VSD closure.},
     year = {2023}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less
    AU  - Mirza Mohd Kamran
    AU  - Shaad Abqari
    AU  - Azam Haseen
    AU  - Mayank Yadav
    Y1  - 2023/05/22
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ijcts.20230901.12
    DO  - 10.11648/j.ijcts.20230901.12
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 5
    EP  - 8
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20230901.12
    AB  - Aim: This study aims to evaluate feasibility and complications of device closure of ventricular septal defect (VSD) in children weighing 5kg. Methods: Between March 2018 and March 2021, total 15 patients with Ventricular Septal Defect (VSD) weighing 5Kg or less were taken to Cath lab for percutaneous VSD closure out of which 13 (86%) had successful transcatheter closure and 2 (14%) cases were unsuccessful and subsequently send for surgical closure. All of these13 patients under went transcatheter closure of VSD using either a Amplatzer duct occluder1, Amplatzer duct Occluder 2 or Amplatzer Muscular VSD Occluder. A retrospective review of the results and related complications was done. Results: Among these 15 patients, 7 were females, 6 were male and the mean age was 8.5 (4-16month. The mean weight in this study was 4.46Kg (2.3-5Kg). Mean VSD size was 4.5 (3-10mm), 9 patients had VSD sizes between 3to5mm, 3 had between5-10 mm and 1 with more than 10mm. Among types of VSD, 9 cases were having Perimembranous, 1 was upper muscular, 1was mid while 1was lower muscular and only 1 had outlet muscular VSD. Amplatzer Duct Occluder (ADOI) was used in 2 cases, 9 were closed with Amplatzer Duct Occluder (ADO2) and 2 were selected for closure with Amplatzer Muscular VSD Occluder. Transthoracic Echocardiography (TTE) in immediate post intervention period revealed all these devices in situ with no or minimal residual flow which subsided within 24 hours period. As far as complications are concerned, we had one device embolization noted in our study. Tricuspid regurgitation (TR) was noted at the time of discharge in 4 patients but subsided after 48 hours while trivial aortic regurgitation was noted (AR) only in one case which is under close follow up and not increasing in severity after 6 months follow-up. Conclusions: Transcatheter closure of VSD in children 5kg or less is feasible and safe alternative to surgical VSD closure.
    VL  - 9
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Pediatric Cardiology, Jawahar Lal Nehru Medical College, Aligarh, India

  • Department of Paediatrics, Jawahar Lal Nehru Medical College, Aligarh, India

  • Department of Cardiovascular and thoracic surgery, Jawahar Lal Nehru Medical College, Aligarh, India

  • Department of Cardiovascular and thoracic surgery, Jawahar Lal Nehru Medical College, Aligarh, India

  • Sections