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Background: To investigate the safety and efficacy of perventricular device closure of perimembranous VSD (pmVSD).
Methods: PubMed and Scopus were searched for studies in English focusing on perventricular device closure of pmVSD published up to the end of March 2019. We used a random-effects model to obtain pooled estimates of the success and complication rates.
Results: A total of 15 publications comprising 1368 patients with pmVSD were included. The median follow-up duration was 2 months to 5 years, with a mean patient age ranging from 2 months to 56 years. The pooled success rate was 0.95 (I = 86.2%, P = 0.000). The pooled rate of postoperative residual shunting was 0.02 (95% CI: 0.01-0.03, I = 87.3%, P < 0.001). The pooled rate of residual shunting in the follow-up period was 0.001 (95% CI:-0.001-0.002, I = 30.5%, P = 0.126). The pooled estimated rate of severe complications was 0.074 (95% CI: 0.046-0.102, I = 30.5%, P = 0.126). The pooled incidence of complete atrioventricular block (cAVB) was 0.002 (95% CI: 0.000-0.005, I = 0.0%, P = 0.577).
Conclusions: Perventricular device closure may be an alternative to conventional surgical repair in selected patients with pmVSD. The success rate was stable regarding the publication year and sample size and suggested both the short learning curve of this technology and its potential for wide application. The incidence of severe arrhythmia, especially cAVB, was low. These good results may be limited by the number of enrolled patients, and a more detailed and larger sample is required for further analysis.
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http://dx.doi.org/10.1186/s13019-019-0936-5 | DOI Listing |
Ann Pediatr Cardiol
July 2024
Department of Pediatric Cardiology and Pediatric Cardiac Surgery, CHU Nantes, Nantes University, FHU PRECICARE, Nantes, France.
Data on the safety and efficiency of perventricular device closure of complex ventricular septal defects (VSDs) are scarce. We report successful one-stage combined hybrid perventricular and percutaneous closure of the muscular VSDs in a critically ill 4-kg infant, using the new multifunctional occluder.
View Article and Find Full Text PDFJ Cardiothorac Surg
July 2024
Division of Pediatric Cardiac Surgery, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, 768010, United Arab Emirates.
Background: Ventricular septal defect (VSD) is the most common congenital cardiac malformation, accounting for approximately 30% of congenital heart defects. Conventional surgical repair using cardiopulmonary bypass is invasive and associated with morbidities and prolonged hospital stay. With the advent of interventional approaches and availability of different occluding devices, the technique of perventricular device closure is evolving and being implemented successfully in larger groups of patients.
View Article and Find Full Text PDFPacing Clin Electrophysiol
September 2024
Department of Pediatric Cardiovascular Surgery, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Despite the advancements in technology, establishing the optimal implantation technique for pediatric patients with a pacemaker (PM) indication remains challenging. Although the implantation of an epicardial PM is recommended, especially in children weighing less than 10 kg, transventricular placement of endocardial leads can be performed safely, offering a practical substitute for an epicardial pacing system, particularly in situations where a transvenous approach is unfeasible due to patient size, anatomical constraints or epicardial PM leads were not available as in our case.
View Article and Find Full Text PDFFront Cardiovasc Med
November 2023
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Background: Ultrasound-guided percutaneous device closure of perimembranous ventricular septal defects (PmVSD) is a minimally invasive recent treatment approach. Perventricular PmVSD device closure is an emerging radiation-free intervention, yet it comes with certain limitations. No studies compared both of these treatment approaches.
View Article and Find Full Text PDFWorld J Pediatr Congenit Heart Surg
January 2024
The Heart Institute, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
We describe the perventricular device closure of a large mid-muscular ventricular septal defect (VSD) in a 2.9 kg infant born with hypoplastic aortic arch and VSD using an Occlutech perimembranous occluder. In this case, the anatomy required a short low-profile device and hence a perimembranous occluder was used.
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