TITLE:
Safety and efficacy of amplatzer duct occluder for percutaneous closure of ventricular septal defects with tunnel shape aneurysm: Medium term follow up
AUTHORS:
Muhammad Dilawar, Zaheer Ahmad
KEYWORDS:
Ventricular Septal Defect; Amplatzer Duct Occluder; Aneurysm
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.2,
April
28,
2013
ABSTRACT: Objectives: Different devices including Amplatzer
duct occluder has been used for percutaneous closure of ventricular septal
defects. This study reports our medium term follow up of perimembranous and
muscular ventricular septal defects with tunnel shape aneurysm closure using the
Amplatzer duct occluder. Materials and Methods: From May 2006-December 2012, we
used Amplatzer duct occluder in seven ventricular septal defect patients here
atHamad General Hospital,Doha,Qatar. There were 4 male and 3 female
patients with an age range of 4 - 32 years with a median of 8 years and weight
range of 16 - 63 kgwith a
median of33 kg. In
this group, 6 were perimembranous and 1 muscular and all these ventricular
septal defects had a tunnel shape aneurysm. Transesophageal echocardiographic diameter ranged from 4 - 8 mmand Qp/Qs was 1 - 1.6. Angiographically,
the diameter on the left ventricular side measured 3.5 - 10 mmand on right ventricular side 2.4- 5 mm. 8/6
mmAmplatzer duct occluder was used to close these ventricular
septal defects. Results: There were no major complications and immediately
after the procedure there was no residual shunt in any of these patients and
all the patients remained in normal sinus rhythm. One patient was expatriate
and no further follow up was available. The rest of the 6 patients had 1 - 80
months with a median of 54 months follow up and none of these patients had any
residual shunt and all remained in normal sinus rhythm. Two patients developed
trivial aortic valve regurgitation immediate post procedure, one remained
unchanged and the 2nd has progressed to mild at this latest follow
up. Conclusion: Amplatzer duct occluder is feasible and a safe device for
percutaneous closure of selective tunnel shape aneurysmal perimembranous and
muscular ventricular septal defects.