Project description:Tricuspid valve (TV) injury following transcatheter closure of perimembranous ventricular septal defect (PMVSD) with Amplatzer ductal occluder I (ADO I), requiring surgical repair, is rare. We report two cases of TV tear involving the anterior and septal leaflets following PMVSD closure using ADO I. In both the patients, the subvalvular apparatus remained unaffected. The patients presented with severe tricuspid regurgitation (TR) 6 weeks and 3 months following the device closure. They underwent surgical repair with patch augmentation of the TV leaflets. Postoperatively, both are asymptomatic with a mild residual TR.

| S-EPMC5241847 | biostudies-literature

Percutaneous closure of post-myocardial infarction ventricular septal rupture - A single centre experience.

Project description:BackgroundPost-infarction ventricular septal rupture (VSR) is a rare but lethal mechanical complication of an acute myocardial infarction (AMI). Survival to 1 month without intervention is 6%. Given high surgical mortality, transcatheter closure has emerged as a potential strategy in selected cases. Indian data on percutaneous device closure of post AMI-VSR is scarce hence we report our single-centre experience with ASD occluder device (Amplatzer and lifetech) for closure of post-AMI VSR.Methods and resultsIn this single-centre, retrospective, cohort study, patients who underwent transcatheter closure of post-MI VSR between 2005 and 2015 at KIMS Hospital were included. Primary outcome was mortality rate at 30 days. Seven patients were included in the study (mean age, 58.29±9.8 years). 5 patients had anterior wall myocardial infarction (AWMI) & 2 had inferior wall myocardial infarction (IWMI). None of the patients received thrombolytic therapy. Device was successfully placed in 5 patients (71.4%) with minimal residual shunt in 2 patients (40%). Out of 7 cases 2 patients survived (29% survival rate) and are doing well on follow up at 1 and 5 years respectively. Cardiogenic shock, IWMI and serpigenious form of VSR were associated with poor outcomes. Delayed revascularization (PCI) was associated with better outcomes.ConclusionPercutaneous closure is a potential technique in a selected group of patients. The presence of cardiogenic shock, IWMI and serpigeneous form of VSR constitutes important risk factors for mortality. Device implantation is in general successful with few procedure-related complications and should be applied on a case-by-case basis.

| S-EPMC5388014 | biostudies-literature

Post-myocardial infarction ventricular septal defect closure with Gore Cardioform atrial septal defect occluder to improve tissue interactions: case report.

Project description:BackgroundGore Cardioform Atrial Septal Defect Occluder (GCA) is composed of a platinum-filled nitinol wire frame covered with expanded polytetrafluoroethylene (ePTFE). This makes the device highly occlusive and resistant to residual shunts through the device, as well as conforming well to the surrounding anatomy. In defects with poor rims to hold a device for closure or where one of the 'rims' is the free wall of the left ventricle, such as in a post-infarct apical ventricular septal defect (VSD), successful closure with standard nitinol mesh devices can be unachievable.Case summaryWe present the occlusion of a post-myocardial infarction VSD with a GCA device in a critically ill patient at risk for closure failure and intravascular haemolysis with conventional nitinol mesh devices. The device conformed well to the anatomy even in the absence of an apical interventricular septum.DiscussionGCA can be used for intracardiac high-velocity shunts in selected cases where conventional devices are unsuitable due to haemolysis or poor tissue and poor rims. With growing experience using GCA for the closure of atrial septal defects, interventionists should consider the potential advantages of ePTFE material and apply them to other lesions where these could be beneficial for patients.

| S-EPMC10409374 | biostudies-literature

Partial Tricuspid Valve Stenosis during Device Closure of Perimembranous Ventricular Septal Defect.

Project description: Not available

| S-EPMC7451896 | biostudies-literature

Disappearing high velocity severe tricuspid regurgitation following Ventricular septal defect device closure.

Project description:This report describes the disappearance of severe high velocity tricuspid regurgitation following a small ventricular septal defect device closure, in an eight year old girl.

| S-EPMC5485395 | biostudies-literature

Percutaneous closure of ventricular septal rupture after myocardial infarction: A retrospective study of 81 cases.

Project description:ObjectiveTo investigate the efficacy and safety of percutaneous closure of ventricular septal rupture (VSR) after acute myocardial infarction (AMI).MethodsThis retrospective study included 81 patients who underwent transcatheter closure for postinfarction VSR. We analyzed clinical data from hospitalization and the 30-day follow-up, compared clinical data from the survival and death groups, and explored the best closure time and the safety and efficacy of occlusion. The risk factors for death at 30 days were analyzed by logistic regression.ResultsC-reactive protein (CRP), white blood cell counts, N-terminal pro brain natriuretic peptide (NT-ProBNP), and aspartate aminotransferase were higher in the death group than in the survival group (p < .01), with a higher rate of application of vasoactive drugs, and a shorter time from AMI to operation (p < .05). At 30 days postocclusion, 19 patients (23.5%) had died. The mortality rate was significantly lower for operation performed 3 weeks after AMI than for operation performed within 3 weeks of AMI (12.5% vs. 48%, p < .001). Devices were successfully implanted in 76 patients, with 16 (21.1%) operation-related complications and 12 (15.8%) valve injuries. Cardiac function improved significantly (p < .001) at discharge (N = 66) and 30 days after procedure (N = 62). Qp/Qs and pulmonary artery systolic pressure decreased significantly, while aortic systolic pressure increased significantly (p < .001). Additionally, EF and LVDd improved (p < .05) after occlusion. Increases in CRP and NT-ProBNP were risk factors for death at 30 days after closure (p < .05).ConclusionPercutaneous VSR closure can be a valuable treatment option for suitable patients with VSR.

| S-EPMC10352964 | biostudies-literature

Concomitant transcatheter closure of post-myocardial infarction ventricular septal defect and inferior wall aneurysm: case report.

Project description:BackgroundThe incidence of the post-infarct ventricular septal defect (VSD) is 0.17%. Surgical repair is the definitive treatment and percutaneous closure is an alternative in high-risk patients. We report a case of post-myocardial infarction inferior wall aneurysm associated with a large ventricular septal rupture, with a communication between the aneurysm and right ventricle. Successful percutaneous closure of both the aneurysm and the post-infarct (VSD) was performed using two Amplatzer septal occluder devices.Case summaryA 76-year-old man was referred to the clinic 2 weeks after an inferior wall myocardial infarction. A harsh, pansystolic murmur was appreciated on his left parasternal area and across the pericardium. An echocardiogram demonstrated a large, true aneurysm in the mid-cavity inferior wall. The inferior septum was ruptured and dissected, with a large, left-to-right shunt. The patient's coronary angiography revealed a multi-vessel disease. The patient was considered as high surgical risk and thus transcatheter closure of both the post-infarct VSD and inferior wall aneurysm was recommended. We crossed the VSD from the venous side. An Amplatzer septal occluder (18 mm) was deployed to close the VSD completely. We crossed the aneurysm mouth from the arterial side. Another Amplatzer septal occluder (26 mm) was deployed with the large disc inside the aneurysm, sealing it with no more flow. After discharge from the intensive care unit, the patient underwent complete revascularization for his right coronary artery, left main artery, proximal left anterior descending artery, and ramus intermedius. At his 3-month follow-up, the patient remained well with reasonable exercise tolerance.DiscussionPercutaneous closure of a post-infarct VSD and aneurysm is an option for patients whose comorbidities preclude surgical repair and whose septal anatomy is favourable to device placement.

| S-EPMC7793211 | biostudies-literature

Postinfarction Ventricular Septal Defect Closure.

Project description: Not available

| S-EPMC6532421 | biostudies-literature

Percutaneous closure of perimembranous ventricular septal defect using patent ductus arteriosus occluders.

Project description:ObjectivesTo assess the safety and efficacy of percutaneous closure of perimembranous ventricular septal defect (PmVSD) using patent ductus arteriosus (PDA) occluders.BackgroundWidespread use of conventional PmVSD closure devices has been limited by unacceptable high rate of complete heart block (CHB). The elegant design of PDA occluders is supposed to ease implantation, increase closure rate and minimize damage to adjacent structures. Thus, PDA occluders may reduce complications, especially the CHB, and offer a good alternative for PmVSD closure.MethodFrom September 2008 to October 2015, patients who underwent attempted percutaneous VSD closure using PDA occluders were included in the study. Patient demographics, echocardiography measurements, procedure details and follow-up data until October 2017 were collected.ResultsIn total, 321 patients with a mean age of 15.5±12.6 years and mean a weight of 33.3±20.5 kg were included in this study. The mean defect size was 4.8±2.1 mm. Implantation was successful in 307 (95.6%) patients. The median follow-up time was 63 months (24 to 108 months). The closure rates were 89.5%, 91.5%, and 99.3% after the procedure 24 hours, 6 months and 2 years, respectively. Major complications occurred in 5 (1.7%) patients during the procedure and follow-up, including persistent CHB in 2 (0.7%) patients and device embolization in 3 (1.0%) patients. No death, disability, or other major complication was detected.ConclusionPercutaneous closure of PmVSD using PDA occluders is feasible, safe and efficacious in selected patients.

| S-EPMC6237304 | biostudies-literature

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