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Mid-term results of percutaneous ventricular septal defect closure with Amplatzer Duct Occluder-II in children
Ozge Pamukcu1, Nazmi Narin1, Ali Baykan1
1Division of Pediatric Cardiology,Erciyes University School of Medicine,Kayseri,Turkey.
Insights
Percutaneous closure of ventricular septal defects using the Amplatzer Duct Occluder-II device is safe and effective in children. This study shows positive mid-term results, even for infants under one year old.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Percutaneous closure of ventricular septal defects (VSDs) is an emerging alternative to surgical repair.
- The development of an ideal device for percutaneous VSD closure remains an ongoing challenge.
Purpose of the Study:
- To evaluate the mid-term outcomes of percutaneous VSD closure using the Amplatzer Duct Occluder-II (ADO-II) device in pediatric patients.
- To assess the safety and efficacy of the ADO-II device, particularly in infants.
Main Methods:
- A retrospective analysis of 49 pediatric patients who underwent percutaneous VSD closure with the ADO-II device between April 2011 and October 2016.
- Included patients with muscular and perimembranous VSDs, with seven patients younger than one year.
Main Results:
- The mean patient age was 86.8 months, and mean weight was 24.3 kg. Mean defect diameter was 3.7 mm.
- Mean fluoroscopy time was 37 minutes and mean procedure time was 74.1 minutes.
- No major complications occurred during procedures; one patient developed complete atrioventricular block at 6 months follow-up. Total follow-up was 66 months.
Conclusions:
- The Amplatzer Duct Occluder-II device demonstrates safety and effectiveness for percutaneous VSD closure in a large pediatric series.
- The device is suitable for use in infants under one year of age, based on the 66-month follow-up data.
Abstract:
Aim The aim of this study was to share the mid-term results of percutaneous ventricular septal defect closure using Amplatzer Duct Occluder-II in children.
Background:
Nowadays, percutaneous ventricular septal defect closure is accepted as an alternative to surgery, but so far no ideal device has been developed for this procedure.
Methods:
In the study centre, between April, 2011 and October, 2016, the ventricular septal defect of 49 patients was closed percutaneously using the Amplatzer Duct Occluder-II device, and seven of them were <1 year old.
Results:
The mean age of patients was 86.8±52.6 months. The mean weight of the patients was 24.3±16 kg. The mean diameter of the defect was 3.7±1.4 mm. Mean fluoroscopy time and total procedure time were 37±19.3 and 74.1±27 minutes, respectively. The types of ventricular septal defects were muscular in six patients, and were perimembranous in the rest of them. We did not face any major complications during the procedure, but one patient was admitted with a complete atrioventricular block in the 6th month of follow-up. The total follow-up period was 66 months.
Conclusion:
To our knowledge, our study includes the largest series of paediatric patients whose ventricular septal defect was closed using Amplatzer Duct Occluder-II percutaneously. When the complications during the 66-month follow-up period are taken into consideration, we can state that Amplatzer Duct Occluder-II is a safe and effective device, even in infants aged <1 year.
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