El Shedoudy Sahar, El-Doklah Eman
Cardiology Department, Tanta University Hospitals, Tanta, Egypt.
J Saudi Heart Assoc. 2019 Apr;31(2):78-87. doi: 10.1016/j.jsha.2018.11.002. Epub 2018 Nov 17.
To assess safety, efficacy and follow-up results of transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud_ Lê VSD Coil (pfm medical, KÖln, Germany).
Transcatheter VSD closure has achieved encouraging results but more follow-up studies are needed.
Between January 2012 and December 2013 in the cardiology department, Tanta University Hospital, Tanta, Egypt, 80 patients underwent percutaneous VSD closure using Nit-Occlud_ Lê VSD Coil. Early and mid- term follow-up was done for 3 years, follow-up was concluded in 2016.
The mean age of patients was 5.34 ± 3 years, and their mean weight was 17.24 ± 8.17 kg. Overall, 77 of 80 patients had perimembranous VSD with aneurysmal tissue; eight had multiple right ventricular exits, 14 had deficient aortic rim, two had high outlet muscular, and one had Gerbode defect. The procedure was successful in 98.75% of patients, and was aborted in one patient because of the development of complete heart block and the coil had to be removed. The mean procedure time was 104.98 ± 9.50 minutes. The mean fluoroscopy time was 30.58 ± 2.79 minutes. The immediate complete occlusion rate was 62%, which increased to 82.3% on the second day, and 94.9% by the 3rd month, and 97.5% by 1 year. There was a significant decrease in mitral incompetence after 6 months of follow-up (p = 0.002), and only one patient had trivial aortic incompetence prior to the procedure that remained the same during follow-up period.
Using Nit-Occlud_ Lê VSD-Coil to close VSD is safe and feasible in VSDs with various morphology.
评估使用Nit-Occlud_ Lê室间隔缺损（VSD）封堵器（德国科隆pfm医疗公司）经导管封堵室间隔缺损的安全性、有效性及随访结果。
经导管室间隔缺损封堵术已取得令人鼓舞的结果，但仍需要更多的随访研究。
2012年1月至2013年12月期间，在埃及坦塔坦塔大学医院心内科，80例患者使用Nit-Occlud_ Lê室间隔缺损封堵器进行了经皮室间隔缺损封堵术。进行了为期3年的早期和中期随访，随访于2016年结束。
患者的平均年龄为5.34±3岁，平均体重为17.24±8.17千克。总体而言，80例患者中有77例为膜周部室间隔缺损伴瘤样组织；8例有多个右心室出口，14例主动脉缘缺失，2例为高位肌部室间隔缺损，1例为Gerbode缺损。98.75%的患者手术成功，1例患者因发生完全性心脏传导阻滞而手术中止，封堵器不得不取出。平均手术时间为104.98±9.50分钟。平均透视时间为30.58±2.79分钟。即刻完全封堵率为62%，第二天升至82.3%，第3个月时为94.9%，1年时为97.5%。随访6个月后二尖瓣反流明显减少（p = 0.002），术前仅1例患者有轻微主动脉反流，随访期间保持不变。
使用Nit-Occlud_ Lê室间隔缺损封堵器封堵各种形态的室间隔缺损安全可行。
