[Percutaneous closure of ventricular septal defect by Amplatzer occluder. Immediate and mid-term follow up results].

OBJECT: To report the immediate and mid-term follow-up results of the Amplatzer membranous VSD occluder for the percutaneous occlusion of the perimembranous VSD.

BACKGROUND

Percutaneous perimembranous VSD occlusion is still considered an experimental method where a variety of devices have been tested. Nowadays, more than 500 membranous Amplatzer devices have been implanted worldwide with encouraging results.

METHOD: We included 6 patients (1 man and 5 women) with a mean age of 9.9 years (range, 3 to 17.5) in whom percutaneous perimembranous VSD closure was attempted.

RESULTS

In one of the patients, positioning of the device was not possible (intention to treat success rate, 83.3%). In the remaining five patients, there was a single defect. The VSD mean diameter with echo was 7 +/- 1.7 mm (range, 5.1 to 9) and with angio was 6.9 +/- 1 (range, 6 to 8). Mean pulmonary pressure was 20.2 +/- 7.7 mm Hg (range, 12-30) and Qp/Qs was 1.69 +/- 0.65 (range, 1.2-2.8). A single device was use in all cases. Immediate angiographic control showed complete occlusion in two patients, trivial shunt in one, and mild shunt in two. Follow-up was at least 4 months. Only one patient has residual trivial shunt, the rest of the defects are completely closed.

CONCLUSION

The special design of the Amplatzer membranous VSD occluder allows percutaneous closure of this defect in a safe and effective way, with good mid-term results. In selected cases, this is a good alternative to surgery in the treatmen of this cardiac defect.