Mohammed Mohammed H A, Tamimi Omar, Al-Mutairi Mansour, Alomrani Ahmed
Department of Cardiac Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.
Sudan J Paediatr. 2022;22(2):172-178. doi: 10.24911/SJP.106-1610253757.
The objective of this study was to review the outcome of patients who underwent transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud Leˆ VSD-Coil.A retrospective study was carried out at King Abdulaziz Cardiac Center on all paediatric patients who underwent interventional VSD closure, during the period from 2011 and 2016. Data were collected, including demographic information, cardiac diagnosis, pre-operative diagnosis, intra-operative findings and postoperative events. Out of 46 patients, who were evaluated for VSD device closure, 17 of them were excluded; 24 patients out of 29 had successful closure of VSD using Nit-Occlud Leˆ VSD-Coil (success rate of 83%), and five cases were referred to surgery. The age group was from 2 years up to 18 years. Almost 90% of VSD was the perimembranous (PM) type (26 patients) and 3 patients (10%) with muscular VSD. Ten of the 26 PM VSDs had TV accessory tissue partially covering the VSD defects. The hemodynamic assessment showed pulmonary blood flow to systemic blood flow ratio (Qp:Qs) > 1.5 in almost all the patients who underwent defect closure. Immediate closure of the defect was achieved in 11/24 patients (45%). In five additional patients, there was a tiny residual and eight with a small residual. With 6 months of follow-up, only six patients remained with tiny residual VSD defects.The Nit-Occlud Leˆ VSD-Coil device has minimal effects on the aortic and tricuspid valves, and there was no permanent atrioventricular block, especially in patients with PM VSDs. Patients with a residual shunt should be followed, especially for haemolysis.
本研究的目的是回顾使用Nit-Occlud Le VSD-Coil经导管闭合室间隔缺损（VSD）患者的治疗结果。在阿卜杜勒阿齐兹国王心脏中心对2011年至2016年期间接受介入性VSD闭合术的所有儿科患者进行了一项回顾性研究。收集了数据，包括人口统计学信息、心脏诊断、术前诊断、术中发现和术后事件。在46例接受VSD装置闭合评估的患者中，17例被排除；29例中的24例使用Nit-Occlud Le VSD-Coil成功闭合了VSD（成功率为83%），5例被转诊进行手术。年龄组为2岁至18岁。几乎90%的VSD为膜周部（PM）型（26例患者），3例（10%）为肌部VSD。26例PM VSD中有10例有三尖瓣附属组织部分覆盖VSD缺损。血流动力学评估显示，几乎所有接受缺损闭合的患者的肺血流量与体循环血流量之比（Qp:Qs）>1.5。11/24例患者（45%）实现了缺损的即刻闭合。另外5例患者有微小残余分流，8例有小残余分流。随访6个月时，只有6例患者仍有微小残余VSD缺损。Nit-Occlud Le VSD-Coil装置对主动脉瓣和三尖瓣的影响极小，且无永久性房室传导阻滞，尤其是在PM VSD患者中。有残余分流的患者应进行随访，尤其是针对溶血情况。
