Transcatheter Closure of Perimembranous Ventricular Septal Defect with Immediate Follow-Up
KRITVIKROM DURONGPISITKUL, MD*, JARUPIM SOONGSWANG, MD*, DUANGMANEE LAOHAPRASITIPORN, MD*, API CHART NANA, MD*, THITIMA NUT AKUL, MD**
Affiliation : *Division of Pediatric Cardiology, Department of Pediatrics, **Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Method : Patients who had membranous VSD with significant left to right shunt as shown by echocardiogram were selected for closure. A standard right and left heart catheterization was done under general anesthesia. A complete arteriovenous wire loop from the aorta to the left ventricle and VSD out into right ventricle was formed in order to guide the delivery sheath into the VSD from the right ventricle. The authors used the new Amplatzer'" Membranous VSD Occluder (AGA Medical Corp., USA) to deploy in the VSD position.
Results : There were 4 patients in the present study with age range of 2 to 24 years old (median : 4 years old). Their weight ranged from 10 to 45 kg (median : 12 kg). Qp:Qs ranged from 1.7-2.5 to l. The device diameter selected was from 6 to 10 mm. All of them were placed without any residual shunt. At one month follow-up all the patients had echocardiographic examination which showed no evidence of residual shunt.
Conclusions : The authors demonstrated that transcatheter closure of membranous VSD could be safely and effectively performed in small children. This device also provided an opportunity for closure of VSD in patients with pulmonary hypertension.
Keywords : Transcatheter Therapy, VSD, Cardiac Catheterization
