Retrograde closure of perimembranous ventricular septal defects. A paradigm shift
To the Editor, The percutaneous closure of ventricular septal defect (VSD) is still not widely used today due to its potential complications (atrioventricular block, valvular heart disease, hemolysis), and technical limitations, particularly, in low-weight patients.1 Devices specifically designed fo...
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| Format: | Article |
| Language: | English |
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Permanyer
2023-02-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
| Online Access: | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=996 |
| _version_ | 1811170134290595840 |
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| author | Alejandro Rasines Rodríguez María Mercedes Aristoy Zabaleta César Abelleira Pardeiro Enrique José Balbacid Domingo Santiago Jiménez Valero Federico Gutiérrez-Larraya Aguado |
| author_facet | Alejandro Rasines Rodríguez María Mercedes Aristoy Zabaleta César Abelleira Pardeiro Enrique José Balbacid Domingo Santiago Jiménez Valero Federico Gutiérrez-Larraya Aguado |
| author_sort | Alejandro Rasines Rodríguez |
| collection | DOAJ |
| description | To the Editor, The percutaneous closure of ventricular septal defect (VSD) is still not widely used today due to its potential complications (atrioventricular block, valvular heart disease, hemolysis), and technical limitations, particularly, in low-weight patients.1 Devices specifically designed for the closure of perimembranous VSD (pmVSD) have an asymmetric design that conditions implantation via antegrade venous access. Therefore, the standard procedure requires creating an arteriovenous loop across the defect to advance the device until its sequential release from the aorta or the left ventricle. An example of this is the Nit-Occlud Lê VSD-Coil device (PFM Medical, Germany) that has a good safety and efficacy profile.2 However, the creation of the loop can be the cause for transient atrioventricular blocks and hemodynamic instability especially in low-weight patients.3 Also, the use of different unspecific occluders—with good clinical outcomes—for this indication has been described, especially if the defect comes with aneurysmal tissue.4 Thanks to their symmetric design and low profile, some devices can be released from the arterial side (retrograde), thus avoiding the creation of the loop. This simplifies the technique, shortens procedural time, and minimizes the dose radiation received by the patient. Such approach has already been described with good clinical outcomes with a specific design... |
| first_indexed | 2024-04-10T16:52:09Z |
| format | Article |
| id | doaj.art-86740539ec1e4e65885ccb4c8fb6ebb5 |
| institution | Directory Open Access Journal |
| issn | 2604-7322 |
| language | English |
| last_indexed | 2024-04-10T16:52:09Z |
| publishDate | 2023-02-01 |
| publisher | Permanyer |
| record_format | Article |
| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj.art-86740539ec1e4e65885ccb4c8fb6ebb52023-02-07T15:43:03ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222023-02-0151737510.24875/RECICE.M22000344Retrograde closure of perimembranous ventricular septal defects. A paradigm shiftAlejandro Rasines Rodríguez0María Mercedes Aristoy Zabaleta1César Abelleira Pardeiro2Enrique José Balbacid Domingo3Santiago Jiménez Valero4Federico Gutiérrez-Larraya Aguado5Servicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología, Sección de Hemodinámica, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainTo the Editor, The percutaneous closure of ventricular septal defect (VSD) is still not widely used today due to its potential complications (atrioventricular block, valvular heart disease, hemolysis), and technical limitations, particularly, in low-weight patients.1 Devices specifically designed for the closure of perimembranous VSD (pmVSD) have an asymmetric design that conditions implantation via antegrade venous access. Therefore, the standard procedure requires creating an arteriovenous loop across the defect to advance the device until its sequential release from the aorta or the left ventricle. An example of this is the Nit-Occlud Lê VSD-Coil device (PFM Medical, Germany) that has a good safety and efficacy profile.2 However, the creation of the loop can be the cause for transient atrioventricular blocks and hemodynamic instability especially in low-weight patients.3 Also, the use of different unspecific occluders—with good clinical outcomes—for this indication has been described, especially if the defect comes with aneurysmal tissue.4 Thanks to their symmetric design and low profile, some devices can be released from the arterial side (retrograde), thus avoiding the creation of the loop. This simplifies the technique, shortens procedural time, and minimizes the dose radiation received by the patient. Such approach has already been described with good clinical outcomes with a specific design...https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=996 |
| spellingShingle | Alejandro Rasines Rodríguez María Mercedes Aristoy Zabaleta César Abelleira Pardeiro Enrique José Balbacid Domingo Santiago Jiménez Valero Federico Gutiérrez-Larraya Aguado Retrograde closure of perimembranous ventricular septal defects. A paradigm shift REC: Interventional Cardiology (English Ed.) |
| title | Retrograde closure of perimembranous ventricular septal defects. A paradigm shift |
| title_full | Retrograde closure of perimembranous ventricular septal defects. A paradigm shift |
| title_fullStr | Retrograde closure of perimembranous ventricular septal defects. A paradigm shift |
| title_full_unstemmed | Retrograde closure of perimembranous ventricular septal defects. A paradigm shift |
| title_short | Retrograde closure of perimembranous ventricular septal defects. A paradigm shift |
| title_sort | retrograde closure of perimembranous ventricular septal defects a paradigm shift |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=996 |
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