DOI 10.1002/ccd.21267
Published online 9 July 2007 in Wiley InterScience
© 2007 Wiley-Liss,
Inc.
Catheterization and Cardiovascular
Interventions
Received 6 April 2007; Revision
accepted 10 May 2007
Transcatheter Closure of High-Risk Muscular Ventricular Septal
Defects With the CardioSEAL Occluder: Initial Report From the CardioSEAL VSD
Registry
Authors
D Scott Lim, MD, Thomas J
Forbes, MD, Abraham Rothman, MD, James E Lock, MD,
Michael J. Landzberg, MD
Source
D. Scott Lim, MD, ChildrenÕs
Hospital Heart Center, University of Virginia, Hospital Expansion, 4th Floor,
Room4038, 1215 Lee Street, Charlottesville, VA 22908-0386.
Email: sl9pc@virginia.edu.
Abstract
Objectives: The
CardioSEAL VSD registry was created to track safety of the device to close
high-risk Ventricular Septal Defect (VSD).
Background: This is
the first report from the multi-centered CardioSEAL VSD registry reviewing
demographics and initial results.
Methods:
Centers recruited patients with VSD who were high-risk for
surgery due to medical condition or anatomic features.
Results: 18 centers
contributed data on 55 high-risk patients who had 61 VSD-occlusion procedures,
with age of range of 5days to 65 years and using one to six devices. Implantation
approach was transvenousin 48, perventricular in five, and by combined approach
in two patients. Ninety-two percent of intended VSD device implants were judged
successful. Twenty-two patients had single VSD closed by single device in 18
and by two devices in four patients. All patients <8 kg underwent
perventricular device implantation. Thirty-three patients had multiple VSDs
which were closed by a single device in 23, and multiple devices in 10.At
discharge echocardiography showed total residual flow through all VSDs in which
devices were used was classified as ÔÔSmallÕÕ or less in 74%, ÔÔMore than
smallÕÕ in 11%, and ÔÔUncertainÕÕ in 15%. Eight major adverse events occurred
in 5/61 cases (8%event rate), with 3/81 devices embolized (4% embolization rate),
5/81 devices surgically explanted (6% explant rate), and no deaths judged to be
procedure-related.
Conclusion: This
initial report from the multi-centered CardioSEAL VSD registry demonstrates the
safety of the device to close high-risk VSDs.