Ghosh Benumadhab, Sahai Isha, Agrawal Gajendra, Khadase Satish, Rao Tarun, Lohakare Akash, Chaturvedi Anuj, Gomase Shantanu
Cardiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2023 Jul 28;15(7):e42591. doi: 10.7759/cureus.42591. eCollection 2023 Jul.
Background Ventricular septal defects (VSDs) are the most common type of septal defects in early infants and are very complicated. This has paved the way for the development of new minimally invasive procedures for interventional cardiologists. This study presents our experience using duct occluders instead of conventional ventricular septal devices in the Department of Cardiology at Acharya Vinoba Bhave Rural Hospital (AVBRH) in central rural India. This study aimed to review success and complications and assess safety and its relation to age, sex, size of the VSDs, type of VSD, and types of devices used after transcatheter closure of perimembranous and muscular VSDs using various types of duct occluders. Methodology This retrospective study included patients who underwent percutaneous VSD device closure at the AVBRH between July 2017 and December 2020. We reviewed the patients' medical records to recognize imaging, clinical, and interventional data pre- and post-procedure and at the last follow-up. Results The success rate of VSD closure was 98.6%, one (0.7%) out of 81 females developed a complication due to device dislodgement, and one male aged six years (0.7%) out of 59 developed a post-procedural complication; hence, the total failure rate was 1.4%. The perimembranous type had no complication, and the muscular type had two (14.3%) unsuccessful procedures. Conclusion This study has concluded an impressive percentage of VSD closure, showing no mortality and low morbidity, using a percutaneous approach with different duct occluders. As the type of device used is not correlated with device failure and failure rate, duct occluders will be financially helpful in the closure of VSD in indicated patients.
背景 室间隔缺损（VSD）是早期婴儿中最常见的间隔缺损类型，且情况非常复杂。这为介入心脏病专家开发新的微创手术铺平了道路。本研究介绍了我们在印度中部农村地区的阿查里亚·维诺巴·巴韦农村医院（AVBRH）心脏病科使用导管封堵器而非传统室间隔装置的经验。本研究旨在回顾经导管使用各种类型导管封堵器闭合膜周部和肌部VSD后的成功率和并发症情况，并评估安全性及其与年龄、性别、VSD大小、VSD类型和所用装置类型的关系。方法 这项回顾性研究纳入了2017年7月至2020年12月期间在AVBRH接受经皮VSD装置闭合术的患者。我们查阅了患者的病历，以识别术前、术后及最后一次随访时的影像学、临床和介入数据。结果 VSD闭合成功率为98.6%，81名女性中有1名（0.7%）因装置移位出现并发症，59名男性中有1名6岁男性（0.7%）术后出现并发症；因此，总失败率为1.4%。膜周部类型无并发症，肌部类型有2例（14.3%）手术失败。结论 本研究得出结论，使用不同导管封堵器经皮闭合VSD的成功率令人印象深刻，无死亡病例且发病率低。由于所用装置类型与装置失败及失败率无关，导管封堵器对符合指征的患者闭合VSD在经济上有帮助。
