Open Access

ARTICLE

Percutaneous closure of perimembranous ventricular septal defects utilizing almost ideal Amplatzer Duct Occluder II: Why limitation in sizes?

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Pediatric Heart Center of Hessen, Goethe University, Frankfurt am Main, Germany

* Corresponding Author: Anoosh Esmaeili, Zentrum der Kinderheilkunde und Jugendmedizin, Pädiatrische Kardiologie und angeborene Herzfehler, Universitätsklinikum Frankfurt, Theodor‐Stern‐Kai 7, 60590 Frankfurt am Main, Germany. Email:

Congenital Heart Disease 2019, 14(3), 389-395. https://doi.org/10.1111/chd.12731

Abstract

Aim: The purpose of this study is to describe the special aspects of perimembranous ventricular septal defects (pmVSD) closure by utilizing Amplatzer Duct Occluder II (ADO II) devices with a rational request for bigger ADO‐II sizes, based on our experi‐ ence in transcatheter device closure of pmVSD.
Methods and Results: At our institution, placement of an ADO II device was used in 15 patients with pmVSD; the patients’ age ranged between 6 months and 20 years. The indications for closure were CHF (n = 4), hemodynamically significant shunt (n = 7), tricuspid regurgitation (n = 3), and high risk for infective endocarditis (n = 2), respectively. The location of the VSD was infracristal in 13 patients, supracristal in 1, and a postsurgical Gerbode VSD in another one. Implantation of the device was suc‐ cessfully performed without embolization, any evidence of an AV block, or other conductance abnormalities during implantation and follow‐up in the mean of 2.5 years (range 2 months‐6.5 years).
Conclusions: Transcatheter closure of a pmVSD with ADO II is feasible in all pediatric and young adult age groups, by considering the device diameter limitations. The off‐ label use of ADO II implantation seems to be safe for VSDs closure up to 6 mm of size and feasible for various locations including unusual morphology such as postsurgical Gerbode defect.

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