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Thorac Cardiovasc Surg 2013; 61(04): 300-306
DOI: 10.1055/s-0033-1334997
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Perventricular Device Closure of Perimembranous Ventricular Septal Defect in Pediatric Patients: Technical and Morphological Considerations

Da Zhu
1   Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
ChangPing Gan
1   Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Xiao Li
2   Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Qi An
1   Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Shuhua Luo
1   Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Hong Tang
2   Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Yuan Feng
2   Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
,
Ke Lin
1   Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
› Author Affiliations
Further Information

Publication History

08 November 2012

18 January 2013

Publication Date:
05 April 2013 (online)

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Abstract

Background We report our experience of using perventricular device closure (PVDC) in treating perimembranous ventricular septal defect (pm-VSD) with emphasis on technical and morphological considerations.

Method Thirty-one pediatric patients with pm-VSD who underwent successful PVDC were enrolled in this study. The pm-VSDs were divided into three different types (type I: tunnel shape; type II: with subaortic rim < 2 mm; type III: membranous aneurysm formation). Four closure strategies were utilized, corresponding to the morphology of the pm-VSD.

Results Mean age of the patients was 2.1 years with mean VSD diameter 5.8 mm. Seven patients had type I VSD, nine presented with type II, and 15 had type III. Twenty-two concentric and nine eccentric devices were used with mean device size 7.3 mm. Complete closure was achieved in 97% of cases during follow-up. Procedure-induced tricuspid regurgitation (TR) was noted in nine patients at discharge; four resolved. Multivariable analysis showed that the procedure-induced TR was associated with the device size (odds ratio = 5.059; 95% confidence interval = 1.431–17.880).

Conclusion Different closure strategies allow for PVDC of various types of pm-VSDs in selected pediatric patients.

Keywords

perventricular device closure - ventricular septal defect - pediatric patients

Note

This article was presented at the 26th EACTS Annual Meeting, Barcelona, Spain.


 

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