Department of Child Health, Sultan Qaboos University, Muscat, Oman.
Department of Pediatric Cardiology, National Heart Center, Muscat, Oman.
Sultan Qaboos Univ Med J. 2020 Nov;20(4):e352-e359. doi: 10.18295/squmj.2020.20.04.012. Epub 2020 Dec 21.
This study aimed to review the experience with percutaneous closure of ventricular septal defects (VSDs) at the National Heart Center (NHC) in Muscat, Oman.
This retrospective study was conducted from November 2008 to December 2017. Patients' electronic medical records were reviewed to identify their clinical, imaging and interventional data before and after the procedure and on the last follow-up.
A total of 116 patients, the majority of which were female (58%), underwent 118 percutaneous procedures for VSD closure at a median age of 3.54 years (range: 0.25-33 years) and a median weight of 12 kg (range: 3.5-78 kg). The mean diameter of the VSDs as determined by transoesophageal echocardiogram was 5.6 ± 1.9 mm (n = 105). The commonest type of VSD was perimembranous (n = 75, 63.5%). Devices were successfully placed during 111 (94.1%) procedures in 109 (94.0%) patients, with the commonest device being a Amplatzer™ duct occluder I (St. Jude Medical, Little Canada, Minnesota, USA; n = 39, 35.1%). There was no mortality. Early major cardiac complications occurred in six patients (5.5%) with device embolisation being the commonest (n = 4, 3.7%). The median follow-up period was 19 months (range: 1-84 months) in 89 (81.7%) of the patients. One patient (0.9%) required a permanent pacemaker for a complete heart block.
This study has demonstrated a good rate of VSD closure with low morbidity and no mortality using the percutaneous approach with different devices. Long-term follow-up is needed to specifically evaluate the function of adjacent structures and the long-term effects on conduction systems.
本研究旨在回顾阿曼马斯喀特国家心脏中心（NHC）经皮室间隔缺损（VSD）封堵术的经验。
本回顾性研究于 2008 年 11 月至 2017 年 12 月进行。回顾患者的电子病历，以确定其在手术前后及最后一次随访时的临床、影像学和介入数据。
共有 116 名患者（其中大多数为女性，占 58%），在中位年龄为 3.54 岁（范围：0.25-33 岁）和中位体重为 12kg（范围：3.5-78kg）时，共进行了 118 次 VSD 封堵经皮手术。经食管超声心动图测量的 VSD 平均直径为 5.6±1.9mm（n=105）。最常见的 VSD 类型是膜周部（n=75，占 63.5%）。在 109 名（94.0%）患者中，111 次（94.1%）手术中成功放置了封堵器，最常用的封堵器是 Amplatzer™ 导管封堵器 I（圣犹达医疗用品有限公司，明尼苏达州，美国；n=39，占 35.1%）。无死亡病例。6 例（5.5%）患者发生早期重大心脏并发症，其中以器械栓塞最常见（n=4，占 3.7%）。89 名（81.7%）患者的中位随访时间为 19 个月（范围：1-84 个月）。1 名患者（0.9%）因完全性心脏传导阻滞需要植入永久性起搏器。
本研究使用不同的封堵器经皮途径治疗 VSD，显示出良好的闭合率、低发病率和无死亡率。需要长期随访来具体评估毗邻结构的功能和对传导系统的长期影响。
