Abstract
Aim: To report the experience of 23 tertiary referral European Centres on transcatheter closure of congenital ventricular septal defects (VSD). Methods and results: Implantation of transcatheter devices was attempted in 430 patients (pts) with congenital VSDs until July 2005. The following anatomic types were present: 119 muscular, 250 perimembranous, 16 multiple, 45 residual post-surgery. Median VSD size was 7 mm (range 3-22), fluoroscopy time 33 min (range 3-146). Devices implanted were Amplatzer muscular or membranous devices in 364, PDA devices in 12, ASD devices in seven, Starflex in seven, and coils in nine patients. Procedure was successful in 410 cases (95%). Complications: device embolization in five cases (surgery in two, catheter retrieval in three), aortic regurgitation in 14 cases (two of which requiring surgery), tricuspid regurgitation in 27 cases (no surgery was necessary), minor rhythm disturbances in 10 pts, death in one patient, complete heart block (cAVB) in 16 pts [perimembranous 12 of 250 (5%), muscular one of 119 (0.8%), residual post-surgery VSD three of 45 (6.7%)]. CAVB was transient in six patients, requiring permanent pace-makers in 10 cases (3.8%) (six early, four late). In the multivariate analysis, the only variable associated with a risk of the occurrence of complication was age (P = 0.012) and weight (P = 0.0035). In the univariate analysis, risk factors for the development of cAVB were, device type (P = 0.03) and VSD location (P = 0.05). After the multivariable Cox proportional hazards analysis, no risk factor was found. Conclusion: Transcatheter closure of congenital VSDs offers encouraging results. Complications are limited; the most relevant one seems to be the device related to cAVB in perimembranous VSD. More experience and long-term follow-up are mandatory to assess safety and effectiveness of this procedure as an alternative to conventional surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 2361-2368 |
| Number of pages | 8 |
| Journal | European Heart Journal |
| Volume | 28 |
| Issue number | 19 |
| DOIs | |
| Publication status | Published - Oct 2007 |
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Keywords
- Transcatheter
- Treatment
- Ventricular septal defect
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Transcatheter closure of congenital ventricular septal defects : Results of the European Registry. / Carminati, Mario; Butera, Gianfranco; Chessa, Massimo; De Giovanni, Joseph; Fisher, Gunter; Gewillig, Marc; Peuster, Mathias; Piechaud, Jean Francois; Santoro, Giuseppe; Sievert, Horst; Spadoni, Isabella; Walsh, Kevin.
In: European Heart Journal, Vol. 28, No. 19, 10.2007, p. 2361-2368.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Transcatheter closure of congenital ventricular septal defects
T2 - Results of the European Registry
AU - Carminati, Mario
AU - Butera, Gianfranco
AU - Chessa, Massimo
AU - De Giovanni, Joseph
AU - Fisher, Gunter
AU - Gewillig, Marc
AU - Peuster, Mathias
AU - Piechaud, Jean Francois
AU - Santoro, Giuseppe
AU - Sievert, Horst
AU - Spadoni, Isabella
AU - Walsh, Kevin
PY - 2007/10
Y1 - 2007/10
N2 - Aim: To report the experience of 23 tertiary referral European Centres on transcatheter closure of congenital ventricular septal defects (VSD). Methods and results: Implantation of transcatheter devices was attempted in 430 patients (pts) with congenital VSDs until July 2005. The following anatomic types were present: 119 muscular, 250 perimembranous, 16 multiple, 45 residual post-surgery. Median VSD size was 7 mm (range 3-22), fluoroscopy time 33 min (range 3-146). Devices implanted were Amplatzer muscular or membranous devices in 364, PDA devices in 12, ASD devices in seven, Starflex in seven, and coils in nine patients. Procedure was successful in 410 cases (95%). Complications: device embolization in five cases (surgery in two, catheter retrieval in three), aortic regurgitation in 14 cases (two of which requiring surgery), tricuspid regurgitation in 27 cases (no surgery was necessary), minor rhythm disturbances in 10 pts, death in one patient, complete heart block (cAVB) in 16 pts [perimembranous 12 of 250 (5%), muscular one of 119 (0.8%), residual post-surgery VSD three of 45 (6.7%)]. CAVB was transient in six patients, requiring permanent pace-makers in 10 cases (3.8%) (six early, four late). In the multivariate analysis, the only variable associated with a risk of the occurrence of complication was age (P = 0.012) and weight (P = 0.0035). In the univariate analysis, risk factors for the development of cAVB were, device type (P = 0.03) and VSD location (P = 0.05). After the multivariable Cox proportional hazards analysis, no risk factor was found. Conclusion: Transcatheter closure of congenital VSDs offers encouraging results. Complications are limited; the most relevant one seems to be the device related to cAVB in perimembranous VSD. More experience and long-term follow-up are mandatory to assess safety and effectiveness of this procedure as an alternative to conventional surgery.
AB - Aim: To report the experience of 23 tertiary referral European Centres on transcatheter closure of congenital ventricular septal defects (VSD). Methods and results: Implantation of transcatheter devices was attempted in 430 patients (pts) with congenital VSDs until July 2005. The following anatomic types were present: 119 muscular, 250 perimembranous, 16 multiple, 45 residual post-surgery. Median VSD size was 7 mm (range 3-22), fluoroscopy time 33 min (range 3-146). Devices implanted were Amplatzer muscular or membranous devices in 364, PDA devices in 12, ASD devices in seven, Starflex in seven, and coils in nine patients. Procedure was successful in 410 cases (95%). Complications: device embolization in five cases (surgery in two, catheter retrieval in three), aortic regurgitation in 14 cases (two of which requiring surgery), tricuspid regurgitation in 27 cases (no surgery was necessary), minor rhythm disturbances in 10 pts, death in one patient, complete heart block (cAVB) in 16 pts [perimembranous 12 of 250 (5%), muscular one of 119 (0.8%), residual post-surgery VSD three of 45 (6.7%)]. CAVB was transient in six patients, requiring permanent pace-makers in 10 cases (3.8%) (six early, four late). In the multivariate analysis, the only variable associated with a risk of the occurrence of complication was age (P = 0.012) and weight (P = 0.0035). In the univariate analysis, risk factors for the development of cAVB were, device type (P = 0.03) and VSD location (P = 0.05). After the multivariable Cox proportional hazards analysis, no risk factor was found. Conclusion: Transcatheter closure of congenital VSDs offers encouraging results. Complications are limited; the most relevant one seems to be the device related to cAVB in perimembranous VSD. More experience and long-term follow-up are mandatory to assess safety and effectiveness of this procedure as an alternative to conventional surgery.
KW - Transcatheter
KW - Treatment
KW - Ventricular septal defect
UR - http://www.scopus.com/inward/record.url?scp=35148843810&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=35148843810&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehm314
DO - 10.1093/eurheartj/ehm314
M3 - Article
C2 - 17684082
AN - SCOPUS:35148843810
VL - 28
SP - 2361
EP - 2368
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 19
ER -