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Retrograde use of the Cardioseal/Starflex occluder device
Christian Jux1, Martin Schneider, Thomas Paul
1Department of Pediatric Cardiology and Pediatric Intensive Care Medicine, Georg-August University Goettingen, Germany. dr.c.jux@medizin.uni-goettingen.de
Insights
The Cardioseal/Starflex device, used for septal defects, was successfully applied retrogradely in two adolescents with congenital heart disease. This novel approach offers effective closure for residual shunting after complex surgical repairs.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- The Cardioseal/Starflex septal occluder is typically deployed via a transvenous sheath for septal defects.
- Congenital heart defects often require surgical palliation, which can sometimes result in residual shunting.
Purpose of the Study:
- To describe the successful retrograde transarterial use of the Cardioseal/Starflex device.
- To demonstrate effective closure of residual left-to-right shunting in complex congenital heart disease cases.
Main Methods:
- A retrograde transarterial approach was utilized in two adolescent patients.
- The Cardioseal/Starflex double-umbrella device was employed for closure.
Main Results:
- Successful closure of residual left-to-right shunting was achieved in both cases.
- Interventions included closure of a large muscular ventricular septal defect post-Mustard operation and a Waterston-Cooley anastomosis.
Conclusions:
- Retrograde use of the Cardioseal/Starflex device is an effective and safe option for selected adolescents and adults.
- This technique provides a valuable alternative for managing residual shunting in complex congenital heart disease.
Abstract:
The Cardioseal/Starflex septal occluder is usually deployed through a long transvenous sheath for closure of atrial septal defects, persistent foramen ovale, and, less commonly, ventricular septal defects. We describe two patients with residual left-to-right shunting after surgical palliation of congenital heart defects and illustrate the successful use of the double-umbrella device in these situations using a retrograde transarterial approach. This is exemplified by two previously not described interventions: retrograde closure of a large muscular ventricular septal defect in a patient after a palliative Mustard operation and a transcatheter closure of a Waterston-Cooley anastomosis. Effective and safe closure of left-to-right shunting can be achieved by retrograde use of the Cardioseal/Starflex device in selected adolescents and grown-ups with congenital heart disease.
