Objective: To evaluate the efficacy of transcatheter closure of perimembranous ventricular septal Defects (VSD) using the new Amplatzer membranous VSD occluder in a short-term follow-up.
Methods: From November 2002 to November 2003, forty-eight patients (25 male, 23 female) with perimembranous VSD underwent an attempt of catheter closure using a new device specially designed for the membranous septum. The mean age of patients was 17 years +/- 12 years (ranged from 3 to 48 years); the mean diameter of VSD measured by transthoracic echocardiography (TTE) was 5.1 mm +/- 1.2 mm (ranged from 3 to 12 mm). Occluder was released through right heart system. All patients would undergo follow-up 1 months, 3 months, 6 months and 12 months after procedures with examination of transthoracic echocardiography, radiography, and electrocardiography.
Results: The devices were deployed successfully in 45 patients. there was complete closure in 36 patients immediately, and tiny (< 3 mm) residual shunt in 5 patients. at the follow-up of 3 months, only two of all patients had a tiny residual shunt. Complete left bundle branch block (LBBB) was found in one patients when he was examined in electrocardiograph 2 weeks later, there were no other severe complications. On a follow-up of 1 to 12 months (mean 3.8 months), all patients were demonstrated a great decrease in their left ventricle end-diastolic dimension (LVEDD) (P < 0.05) and no other late complications.
Conclusion: Transcatheter closure of membranous VSD using this new occluder is safe and effective, the results of short-term follow-up was satisfied. Further clinical trials are underway to assess the long-term results.