Transcatheter closure of muscular ventricular septal defects with the amplatzer ventricular septal defect occluder: initial clinical applications in children

J Am Coll Cardiol. 1999 Apr;33(5):1395-9. doi: 10.1016/s0735-1097(99)00011-x.


Objectives: The aim of this study was to close muscular ventricular septal defects (MVSDs) in children, with a new device, the Amplatzer ventricular septal defect occluder (AVSDO).

Background: The design of previously used devices for transcatheter closure of MVSDs is not ideal for this purpose and their use has been limited by several drawbacks.

Methods: Six patients, aged 3 to 10 years, with MVSDs underwent transcatheter closure using the AVSDO. The device is a modified self-centering and repositionable Amplatzer device that consists of two low profile disks made of Nitinol wire mesh with a 7-mm connecting waist. The prosthesis size (connecting waist diameter) was chosen according to the measured balloon stretched VSD diameters. A 6-F or 7-F sheath was used for the delivery of the AVSDO. Fluoroscopy and transesophageal echocardiography were utilized for optimal guidance.

Results: The location of the defect was midmuscular in five patients and beneath the pulmonary valve in one. The balloon stretched MVSD diameter ranged from 6 to 11 mm. Device placement was successful in all patients, and complete occlusion occurred in all six patients (95% confidence interval 54.06% to 100%). Two patients developed transient complete left bundle branch block. No other complications were observed.

Conclusions: This encouraging initial clinical success indicates that the AVSDO is a promising device for transcatheter closure of MVSDs in children. Further clinical trials and longer follow-up are needed before the widespread use of this technique can be recommended.

Publication types

  • Comparative Study

MeSH terms

  • Cardiac Catheterization* / instrumentation
  • Cardiac Surgical Procedures / methods*
  • Child
  • Child, Preschool
  • Coronary Angiography
  • Echocardiography, Doppler, Color
  • Echocardiography, Transesophageal
  • Fluoroscopy
  • Follow-Up Studies
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Heart Septal Defects, Ventricular / surgery*
  • Humans
  • Prosthesis Design
  • Prosthesis Implantation / instrumentation*
  • Retrospective Studies
  • Treatment Outcome