Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg
IntroductionDevice closure of perimembranous ventricular septal defects (pmVSD) is a successful off-label treatment alternative. We aim to report and compare the outcomes of pmVSD closure in children weighing less than 10 kg using Amplatzer Duct Occluder II (ADOII) and Konar-MF VSD Occluder (MFO) de...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1255808/full |
| _version_ | 1797448603573157888 |
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| author | Kaan Yildiz Nazmi Narin Sedef Oksuz Rahmi Ozdemir Ozge Pamukcu Ali Baykan Abdullah Ozyurt Sedat Bagli Rasit Aktas Ikbal Nur Safak Muhammed Akif Atlan Yunus Sezer Bayam Cem Karadeniz |
| author_facet | Kaan Yildiz Nazmi Narin Sedef Oksuz Rahmi Ozdemir Ozge Pamukcu Ali Baykan Abdullah Ozyurt Sedat Bagli Rasit Aktas Ikbal Nur Safak Muhammed Akif Atlan Yunus Sezer Bayam Cem Karadeniz |
| author_sort | Kaan Yildiz |
| collection | DOAJ |
| description | IntroductionDevice closure of perimembranous ventricular septal defects (pmVSD) is a successful off-label treatment alternative. We aim to report and compare the outcomes of pmVSD closure in children weighing less than 10 kg using Amplatzer Duct Occluder II (ADOII) and Konar-MF VSD Occluder (MFO) devices.MethodsRetrospective clinical data review of 52 children with hemodynamically significant pmVSD, and sent for transcatheter closure using ADOII and MFO, between January 2018 and January 2023. Baseline, procedural, and follow-up data were compared according to the implanted deviceResultsADOII devices were implanted in 22 children with a median age of 11 months (IQR, 4.1–14.7) and weight of 7.4 kg (IQR, 2.7–9.7). MFO devices were implanted in 30 children with a median age of 11 months (IQR, 4.8–16.6) and weight of 8 kg (IQR, 4.1–9.6). ADOII were implanted (retrograde, 68.1%) in defects with a median left ventricular diameter of 4.6 mm (IQR, 3.8–5.7) and right ventricular diameter of 3.5 mm (IQR, 3.1–4.9) while MFO were implanted (antegrade, 63.3%) in defects with a median left ventricular diameter of 7 mm (IQR, 5.2–11.3) (p > 0.05) and right ventricular diameter of 5 mm (IQR, 2.0, 3.5–6.2) (p < 0.05). The procedural and fluoroscopy times were shorter with the MFO device (p < 0.05). On a median follow-up of 41.2 months (IQR, 19.7–49.3), valvular insufficiency was not observed. One 13-month-old child (6.3 kg) with ADOII developed a complete atrioventricular heart block (CAVB) six months postoperative and required pacemaker implantation. One 11-month-old child (5.9 kg) with MFO developed a CAVB 3 days postoperative and the device was removed. At 6 months post-procedure, only one child with MFO still experiences a minor residual shunt. There was one arterio-venous fistula that resolved spontaneously.ConclusionBoth the MFO and ADOII are effective closure devices in appropriately selected pmVSDs. CAVB can occur with both devices. The MFO is inherently advantageous for defects larger than 6 mm and subaortic rims smaller than 3 mm. In the literature, our series represents the first study comparing the mid-term outcomes of MFO and ADOII devices in children weighing less than 10 kg. |
| first_indexed | 2024-03-09T14:12:55Z |
| format | Article |
| id | doaj.art-972ca847ecbc4916805f8b3460ce4c04 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-09T14:12:55Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-972ca847ecbc4916805f8b3460ce4c042023-11-29T05:55:20ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-11-011010.3389/fcvm.2023.12558081255808Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kgKaan Yildiz0Nazmi Narin1Sedef Oksuz2Rahmi Ozdemir3Ozge Pamukcu4Ali Baykan5Abdullah Ozyurt6Sedat Bagli7Rasit Aktas8Ikbal Nur Safak9Muhammed Akif Atlan10Yunus Sezer Bayam11Cem Karadeniz12Department of Pediatric Cardiology, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatric Cardiology Izmir, Katip Celebi University Faculty of Medicine, Izmir, TürkiyeDepartment of Pediatric Cardiology, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatric Cardiology Izmir, Katip Celebi University Faculty of Medicine, Izmir, TürkiyeDepartment of Pediatric Cardiology, Erciyes University Faculty of Medicine, Kayseri, TürkiyeDepartment of Pediatric Cardiology, Erciyes University Faculty of Medicine, Kayseri, TürkiyeDepartment of Pediatric Cardiology, Istinye University Faculty of Medicine, Istanbul, TürkiyeDepartment of Pediatric Cardiology, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatric Cardiology, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatric Cardiology, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatric Cardiology, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatrics, SBU Tepecik Training and Research Hospital, Izmir, TürkiyeDepartment of Pediatric Cardiology Izmir, Katip Celebi University Faculty of Medicine, Izmir, TürkiyeIntroductionDevice closure of perimembranous ventricular septal defects (pmVSD) is a successful off-label treatment alternative. We aim to report and compare the outcomes of pmVSD closure in children weighing less than 10 kg using Amplatzer Duct Occluder II (ADOII) and Konar-MF VSD Occluder (MFO) devices.MethodsRetrospective clinical data review of 52 children with hemodynamically significant pmVSD, and sent for transcatheter closure using ADOII and MFO, between January 2018 and January 2023. Baseline, procedural, and follow-up data were compared according to the implanted deviceResultsADOII devices were implanted in 22 children with a median age of 11 months (IQR, 4.1–14.7) and weight of 7.4 kg (IQR, 2.7–9.7). MFO devices were implanted in 30 children with a median age of 11 months (IQR, 4.8–16.6) and weight of 8 kg (IQR, 4.1–9.6). ADOII were implanted (retrograde, 68.1%) in defects with a median left ventricular diameter of 4.6 mm (IQR, 3.8–5.7) and right ventricular diameter of 3.5 mm (IQR, 3.1–4.9) while MFO were implanted (antegrade, 63.3%) in defects with a median left ventricular diameter of 7 mm (IQR, 5.2–11.3) (p > 0.05) and right ventricular diameter of 5 mm (IQR, 2.0, 3.5–6.2) (p < 0.05). The procedural and fluoroscopy times were shorter with the MFO device (p < 0.05). On a median follow-up of 41.2 months (IQR, 19.7–49.3), valvular insufficiency was not observed. One 13-month-old child (6.3 kg) with ADOII developed a complete atrioventricular heart block (CAVB) six months postoperative and required pacemaker implantation. One 11-month-old child (5.9 kg) with MFO developed a CAVB 3 days postoperative and the device was removed. At 6 months post-procedure, only one child with MFO still experiences a minor residual shunt. There was one arterio-venous fistula that resolved spontaneously.ConclusionBoth the MFO and ADOII are effective closure devices in appropriately selected pmVSDs. CAVB can occur with both devices. The MFO is inherently advantageous for defects larger than 6 mm and subaortic rims smaller than 3 mm. In the literature, our series represents the first study comparing the mid-term outcomes of MFO and ADOII devices in children weighing less than 10 kg.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1255808/fullventricular septal defecttranscatheter closureweight >10 kgAmplatzer ductKONAR-multi functional occluder |
| spellingShingle | Kaan Yildiz Nazmi Narin Sedef Oksuz Rahmi Ozdemir Ozge Pamukcu Ali Baykan Abdullah Ozyurt Sedat Bagli Rasit Aktas Ikbal Nur Safak Muhammed Akif Atlan Yunus Sezer Bayam Cem Karadeniz Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg Frontiers in Cardiovascular Medicine ventricular septal defect transcatheter closure weight >10 kg Amplatzer duct KONAR-multi functional occluder |
| title | Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg |
| title_full | Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg |
| title_fullStr | Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg |
| title_full_unstemmed | Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg |
| title_short | Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg |
| title_sort | safety and efficacy of amplatzer duct occluder ii and konar mf™ vsd occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg |
| topic | ventricular septal defect transcatheter closure weight >10 kg Amplatzer duct KONAR-multi functional occluder |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1255808/full |
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