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Postinfarction ventricular septal defect closure with Amplatzer occluders.
M Szkutnik1, J Bialkowski, J Kusa
1Congenital Heart Defects and Pediatric Cardiology Department, Silesian Centre for Heart Diseases, ul. Szpitalna 2, 41-800 Zabrze, Poland. jabi_med@priv4.onet.pl
Summary
Transcatheter closure of postinfarction ventricular septal defect (PIVSD) using Amplatzer occluders offers a promising treatment option. This minimally invasive approach achieved significant clinical improvement in most patients with subacute PIVSD.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Postinfarction ventricular septal defect (PIVSD) is a rare but severe complication of myocardial infarction.
- Surgical and medical treatments for PIVSD carry high risks.
- Transcatheter closure presents an alternative therapeutic strategy.
Purpose of the Study:
- To evaluate the efficacy and safety of transcatheter closure for subacute PIVSD.
- To report outcomes using Amplatzer occluders for PIVSD treatment.
Main Methods:
- Seven patients (51-71 years) with subacute PIVSD underwent transcatheter closure.
- Procedures were performed 2-10 weeks post-myocardial infarction.
- Amplatzer atrial septal occluders (ASO) and one VSD occluder (VSO) were implanted via jugular or transfemoral venous access.
Main Results:
- Successful closure was achieved in five of seven patients.
- Immediate clinical improvement was observed in successfully treated patients.
- Complications included procedural difficulties, ventricular fibrillation, and one mortality due to multiorgan failure.
Conclusions:
- Transcatheter closure with Amplatzer occluders is an attractive option for subacute PIVSD.
- Despite technical challenges, the procedure offers significant benefits.
- Further investigation into optimizing this technique is warranted.