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Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder

Journal Article:

Abstract

Objective: To evaluate the feasibility and efficacy of transcatheter perimembranous ventricular septal defects (VSD) occlusion with home-made nitinol occluder. Methods: Transcatheter closure was attempted in 196 patients with perimembranous VSD. The diameter of VSD measured by echocardiography was 3 to 15 mm, mean (4.94 {+-} 2.23) mm. The angiographic diameter of the VSD was 3 to 6 mm, mean (3.92 {+-} 1.44) mm. A 7-10 F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein to deploy the occluder with the guidance of echocardiography and fluoroscopy. The device diameter selected was from 4 to 20 mm, mean (6.68 {+-} 2.76) mm. Left ventriculography and transthoracic echocardiography were repeated to assess the closure of the defects 15 min after the procedure. Continuous electrocardiogram monitoring lasted for 5 days. The echocardiography and electrocardiogram examination were scheduled for 1, 6 and 12 months of follow-up. Results: The occluders were successfully deployed in 191 patients. There were five procedural failures, two with device-related aortic insufficiency, and three of inability to pass through VSD. After deployment of the devices, there were no residual shunt in 180 of 191 patients, 11 patients with a trivial residual shunt that disappeared in 8  More>>
Authors:
Yongwen, Qin; Xianxian, Zhao; Xing, Zheng; Jijun, Ding; Jiang, Cao [1] 
  1. Second Military Medical Univ., Shanghai (China). Changhai Hospital, Dept. of Cardiology
Publication Date:
Apr 01, 2004
Product Type:
Journal Article
Resource Relation:
Journal Name: Journal of Interventional Radiology; Journal Volume: 13; Journal Issue: 2; Other Information: 1 fig., 11 refs
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; CARDIOVASCULAR DISEASES; EVALUATION; HEART; IMPLANTS; MEDICAL SURVEILLANCE; SURGERY; ULTRASONOGRAPHY
OSTI ID:
20665556
Country of Origin:
China
Language:
Chinese
Other Identifying Numbers:
Journal ID: ISSN 1008-794X; TRN: CN0502409103544
Submitting Site:
INIS
Size:
page(s) 104-107
Announcement Date:
Dec 08, 2005

Journal Article:

Citation Formats

Yongwen, Qin, Xianxian, Zhao, Xing, Zheng, Jijun, Ding, and Jiang, Cao. Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder. China: N. p., 2004. Web.
Yongwen, Qin, Xianxian, Zhao, Xing, Zheng, Jijun, Ding, & Jiang, Cao. Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder. China.
Yongwen, Qin, Xianxian, Zhao, Xing, Zheng, Jijun, Ding, and Jiang, Cao. 2004. "Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder." China.
@misc{etde_20665556,
title = {Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder}
author = {Yongwen, Qin, Xianxian, Zhao, Xing, Zheng, Jijun, Ding, and Jiang, Cao}
abstractNote = {Objective: To evaluate the feasibility and efficacy of transcatheter perimembranous ventricular septal defects (VSD) occlusion with home-made nitinol occluder. Methods: Transcatheter closure was attempted in 196 patients with perimembranous VSD. The diameter of VSD measured by echocardiography was 3 to 15 mm, mean (4.94 {+-} 2.23) mm. The angiographic diameter of the VSD was 3 to 6 mm, mean (3.92 {+-} 1.44) mm. A 7-10 F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein to deploy the occluder with the guidance of echocardiography and fluoroscopy. The device diameter selected was from 4 to 20 mm, mean (6.68 {+-} 2.76) mm. Left ventriculography and transthoracic echocardiography were repeated to assess the closure of the defects 15 min after the procedure. Continuous electrocardiogram monitoring lasted for 5 days. The echocardiography and electrocardiogram examination were scheduled for 1, 6 and 12 months of follow-up. Results: The occluders were successfully deployed in 191 patients. There were five procedural failures, two with device-related aortic insufficiency, and three of inability to pass through VSD. After deployment of the devices, there were no residual shunt in 180 of 191 patients, 11 patients with a trivial residual shunt that disappeared in 8 patients after one month of follow up. 3 patients developed mild tricuspid insufficiency. 12 developed transient complete right bundle branch block, and 5 transient complete left bundle branch block, and 2 transient complete atrioventricular block. There were repetitive nonparoxysmal ventricular tachycardia in 4 patients 1 week after the procedure. One patient had a detached device embolized into the left pulmonary artery but with a successful catheter retrieval by snare and transcatheter closure. The devices were similarly applied to patients with VSD associated with patent ductus arteriosus, and 4 patients with VSD complicated by atrial septal defects. The fluoroscopy time for the procedure was (13.2 {+-} 7.7) min (range from 5 to 60 min). The procedure time was (59.5 {+-} 18.2) min (range, 39 to 160 min). On follow-up evaluation of 1 month to 2 years, there were no episodes of endocarditis, thromboembolism and hemolysis. Conclusion: Transcatheter closure of membranous ventricular septal defects with homemade nitinol occluder is effective, easy and safe. (author)}
journal = {Journal of Interventional Radiology}
issue = {2}
volume = {13}
place = {China}
year = {2004}
month = {Apr}
}