Abstract
Introduction: Transcatheter treatment of congenital heart defects in adult patients is dramatically changing the way in which this population is being treated. This report outlines mid-term follow-up results and complications in adult patients that underwent transcatheter VSD closure. Methods: The data of 40 adult patients who underwent transcatheter closure of a VSD at our institution were collected prospectively between January 2000 and June 2006. The inclusion criteria for this study were clinical and/or echocardiographic evidence of a significant left-to-right shunt through a muscular VSD (mVSD) or a perimembranous VSD (pVSD). A shunt was considered significant when the following were found: (i) left atrial enlargement, defined as a left atrial-to-aortic ratio > 1.5; (ii) left ventricular enlargement (left ventricular overload), defined as a left ventricular end-diastolic diameter >+ 2 standard deviation (SD) above the mean for the patient's age. Another inclusion criterion was a previous episode of endocarditis. Results: 41 procedures were carried out in 40 patients; a mVSD-O was used in 22 patients and a pVSD-O in 18 patients (1 patient had two devices inserted). No deaths occurred; no procedure was aborted. A total of 6 (14.6%) complications occurred. The most frequent complication was a rhythm abnormality (n = 4). No device embolization occurred. The median follow-up duration was 36 months (range: 6-81 months). No deaths or cases of endocarditis occurred. One patient who had two devices implanted because of a residual defect after a tetralogy of Fallot repair, had to be operated again 3 months after the second device implantation because of a persistent significant residual leak. Conclusions: Greater experience, possibly of multicentre trials and long-term follow-up are required to better assess the safety and effectiveness of this procedure as an alternative to surgical approaches in adult patients.
| Original language | English |
|---|---|
| Pages (from-to) | 70-73 |
| Number of pages | 4 |
| Journal | International Journal of Cardiology |
| Volume | 133 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Mar 20 2009 |
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Keywords
- Congenital heart defects
- GUCH
- Interventional cardiology
- Ventricular septal defect
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Transcatheter closure of congenital ventricular septal defects in adult : Mid-term results and complications. / Chessa, Massimo; Butera, Gianfranco; Negura, Diana; Bussadori, Claudio; Giamberti, Alessandro; Fesslova, Vlasta; Carminati, Mario.
In: International Journal of Cardiology, Vol. 133, No. 1, 20.03.2009, p. 70-73.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Transcatheter closure of congenital ventricular septal defects in adult
T2 - Mid-term results and complications
AU - Chessa, Massimo
AU - Butera, Gianfranco
AU - Negura, Diana
AU - Bussadori, Claudio
AU - Giamberti, Alessandro
AU - Fesslova, Vlasta
AU - Carminati, Mario
PY - 2009/3/20
Y1 - 2009/3/20
N2 - Introduction: Transcatheter treatment of congenital heart defects in adult patients is dramatically changing the way in which this population is being treated. This report outlines mid-term follow-up results and complications in adult patients that underwent transcatheter VSD closure. Methods: The data of 40 adult patients who underwent transcatheter closure of a VSD at our institution were collected prospectively between January 2000 and June 2006. The inclusion criteria for this study were clinical and/or echocardiographic evidence of a significant left-to-right shunt through a muscular VSD (mVSD) or a perimembranous VSD (pVSD). A shunt was considered significant when the following were found: (i) left atrial enlargement, defined as a left atrial-to-aortic ratio > 1.5; (ii) left ventricular enlargement (left ventricular overload), defined as a left ventricular end-diastolic diameter >+ 2 standard deviation (SD) above the mean for the patient's age. Another inclusion criterion was a previous episode of endocarditis. Results: 41 procedures were carried out in 40 patients; a mVSD-O was used in 22 patients and a pVSD-O in 18 patients (1 patient had two devices inserted). No deaths occurred; no procedure was aborted. A total of 6 (14.6%) complications occurred. The most frequent complication was a rhythm abnormality (n = 4). No device embolization occurred. The median follow-up duration was 36 months (range: 6-81 months). No deaths or cases of endocarditis occurred. One patient who had two devices implanted because of a residual defect after a tetralogy of Fallot repair, had to be operated again 3 months after the second device implantation because of a persistent significant residual leak. Conclusions: Greater experience, possibly of multicentre trials and long-term follow-up are required to better assess the safety and effectiveness of this procedure as an alternative to surgical approaches in adult patients.
AB - Introduction: Transcatheter treatment of congenital heart defects in adult patients is dramatically changing the way in which this population is being treated. This report outlines mid-term follow-up results and complications in adult patients that underwent transcatheter VSD closure. Methods: The data of 40 adult patients who underwent transcatheter closure of a VSD at our institution were collected prospectively between January 2000 and June 2006. The inclusion criteria for this study were clinical and/or echocardiographic evidence of a significant left-to-right shunt through a muscular VSD (mVSD) or a perimembranous VSD (pVSD). A shunt was considered significant when the following were found: (i) left atrial enlargement, defined as a left atrial-to-aortic ratio > 1.5; (ii) left ventricular enlargement (left ventricular overload), defined as a left ventricular end-diastolic diameter >+ 2 standard deviation (SD) above the mean for the patient's age. Another inclusion criterion was a previous episode of endocarditis. Results: 41 procedures were carried out in 40 patients; a mVSD-O was used in 22 patients and a pVSD-O in 18 patients (1 patient had two devices inserted). No deaths occurred; no procedure was aborted. A total of 6 (14.6%) complications occurred. The most frequent complication was a rhythm abnormality (n = 4). No device embolization occurred. The median follow-up duration was 36 months (range: 6-81 months). No deaths or cases of endocarditis occurred. One patient who had two devices implanted because of a residual defect after a tetralogy of Fallot repair, had to be operated again 3 months after the second device implantation because of a persistent significant residual leak. Conclusions: Greater experience, possibly of multicentre trials and long-term follow-up are required to better assess the safety and effectiveness of this procedure as an alternative to surgical approaches in adult patients.
KW - Congenital heart defects
KW - GUCH
KW - Interventional cardiology
KW - Ventricular septal defect
UR - http://www.scopus.com/inward/record.url?scp=61449250896&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=61449250896&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2007.11.098
DO - 10.1016/j.ijcard.2007.11.098
M3 - Article
C2 - 18234370
AN - SCOPUS:61449250896
VL - 133
SP - 70
EP - 73
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -