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  • Title: Transcatheter closure of perimembranous ventricular septal defects with ductal occluders.
    Author: Mahimarangaiah J, Subramanian A, Kikkeri Hemannasetty S, Chandra S, Karur S, Mandikal Kodandaramasastry U, Cholenahally Nanjappa M.
    Journal: Cardiol Young; 2015 Jun; 25(5):918-26. PubMed ID: 25022868.
    Abstract:
    BACKGROUND: To study the feasibility and complications associated with the use of ductal occluders for closure of perimembranous ventricular septal defects. METHODS: A total of 126 patients, ranging from 1 to 41 years of age (median - 8 years), underwent closure of ventricular septal defects from August 2010 to April 2013. Small- and moderate-sized defects were closed using first-generation Patent ductus arteriosus occluders or Amplatzer Duct Occluder-II. Patients were followed up for the development of complications such as heart block, aortic regurgitation, and tricuspid regurgitation. RESULTS: Patent ductus arteriosus occluders were used in 81 patients, and the Amplatzer Duct Occluder-II device in 45 patients. The devices were successfully deployed in 99.2% of the cases. One patient had embolisation of an Amplatzer Duct Occluder-II device soon after deployment. There was one case of transient complete heart block (0.8%) needing temporary pacing, and two cases of isoarrhythmic atrioventricular dissociation (1.6%). One patient developed late-onset complete heart block 15 months after the procedure and underwent permanent pacemaker implantation. There were no instances of new-onset aortic regurgitation. New-onset mild tricuspid regurgitation was seen in two patients. Of the patients, three had small residual shunts on follow-up, without haemolysis. CONCLUSIONS: Duct occluders can be used to effectively close small- and moderate-sized ventricular septal defects. The incidence of complete heart block and valvular regurgitations are much less than reported with other devices, and they are cost-effective.
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