Percutaneous closure of ventricular septal defects in children aged <12 : early and mid-term results

• Published in: European heart journal 2006-12, Vol.27 (23), p.2889-2895
• Main Authors: BUTERA, Gianfranco, CARMINATI, Mario, FRIGIOLA, Alessandro, CHESSA, Massimo, PIAZZA, Luciane, ABELLA, Raul, NEGURA, Diana Gabriella, GIAMBERTI, Alessandro, CLAUDIO, Bussadori, MICHELETTI, Angelo, TAMMAM, Youssef
• Format: Article
• Language: English
• Subjects: Arrhythmias, Cardiac - etiology; Balloon Occlusion - adverse effects; Balloon Occlusion - methods; Biological and medical sciences; Cardiology. Vascular system; Child; Child, Preschool; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Equipment Failure; Female; Femoral Artery; Follow-Up Studies; Heart; Heart Block - etiology; Heart Septal Defects, Ventricular - therapy; Heart Valve Diseases - etiology; Humans; Infant; Length of Stay; Male; Medical sciences; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Risk Factors; Thrombosis - etiology; Treatment Outcome
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehl340

The aim of the article is to study the safety, efficacy, and follow-up of percutaneous closure of muscular ventricular septal defect (mVSD) and perimembranous ventricular septal defect (pmVSD) in children. Between January 2000 and June 2005, among 140 patients who underwent percutaneous closure of an mVSD or a pmVSD, 88 were aged lt;12. Two different Amplatzer devices were used: the mVSD occluder and the pmVSD occluder. Mean age and weight at procedure were 4.5+/-3.3 years and 18.7+/-11.2 kg, respectively. Percutaneous closure was successfully achieved in 83 subjects (94%). No deaths occurred. Thirteen patients (14.7%) had early complications: device embolization (n=4), vascular complications (n=3), and rhythm abnormalities (n=6). These were transient complications in all but one case [1.1% complete atrioventricular block (cAVB) needing pacemaker implantation]. During a median follow-up of 24 months, three subjects treated for a pmVSD needed pacemaker implantation due to the occurrence of cAVB. Multivariable analysis using Cox's proportional hazard regression showed that age was the only risk factor associated with the occurrence of cAVB (P=0.028; relative risk: 0.25). Percutaneous closure of mVSD and pmVSD in children can be performed safely and successfully. The occurrence of cAVB is a major concern in young children with pmVSD.