Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2019; 7(5): 562-571
Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.562
Safety of an improved patent ductus arteriosus occluder for transcatheter closure of perimembranous ventricular septal defects with abnormally attached tricuspid chordae tendineae
Lu He, Ya-Juan Du, Ge-Sheng Cheng, Yu-Shun Zhang
Lu He, Ya-Juan Du, Ge-Sheng Cheng, Yu-Shun Zhang, Department of Structural Heart Disease, Xi’an Jiaotong University Medical College First Affiliated Hospital, Xi’an 710061, Shaanxi Province, China
Author contributions: He L and Zhang YS contributed to study concept and design; Du YJ and Cheng GS contributed to data analysis and interpretation and critical revision of the article; He L contributed to drafting of the article; all the authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the ethics committee of Xi’an Jiaotong University Medical College First Affiliated Hospital (Xi’an, China).
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: None.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yu-Shun Zhang, MD, PhD, Professor, Department of Structural Heart Disease, Xi’an Jiaotong University Medical College First Affiliated Hospital, 277 Yanta West Road, Xi'an 710061, Shaanxi Province, China. zys2889@sina.com
Telephone: +86-29-85324078 Fax: +86-29-85324078
Received: December 22, 2018
Peer-review started: December 23, 2018
First decision: December 29, 2018
Revised: January 13, 2019
Accepted: January 29, 2019
Article in press: January 30, 2019
Published online: March 6, 2019
Processing time: 74 Days and 19.6 Hours
Abstract
BACKGROUND

The off-label use of various devices has been reported for the transcatheter closure of perimembranous ventricular septal defects (PmVSD) because of serious complications, such as heart block and tricuspid regurgitation (TR), associated with conventional ventricular septal defect devices. However, whether certain defects such as PmVSD with abnormally attached tricuspid are fit for interventional treatment is still disputable.

AIM

To explore the feasibility and safety of transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae using an improved patent ductus arteriosus (PDA) occluder.

METHODS

We retrospectively analyzed 20 patients diagnosed with PmVSD with abnormally attached tricuspid chordae tendineae who underwent interventional treatment using an improved PDA occluder at our center from January 2012 to January 2016. Baseline characteristics and procedural and follow-up data were analyzed.

RESULTS

All 20 patients achieved procedure success. No heart block occurred during the operation. One patient had a transient complete right bundle branch block within 48 h post-procedure and reverted to normal rhythm after intravenous injections of dexamethasone for 3 d. For all 20 patients, no residual shunt was observed by transthoracic echocardiography post-procedure. During the average follow-up period of 2.4 years, no severe TR was observed.

CONCLUSION

Using of the improved PDA occluder for the transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae is a safe and promising treatment option. However, long-term follow-up in a large group of patients is still warranted.

Keywords: Ventricular septal defect; Transcatheter; Patent ductus arteriosus occlude; Tricuspid regurgitation; Chordae tendineae

Core tip: The aim of this study was to explore the feasibility and safety of transcatheter closure of perimembranous ventricular septal defects (PmVSD) with abnormally attached tricuspid chordae tendineae using an improved PDA occluder. A total of 20 patients diagnosed with PmVSD with abnormally attached tricuspid chordae tendineae who underwent interventional treatment using the improved patent ductus arteriosus (PDA) occluder were observed. All 20 patients achieved procedure success, and no residual shunt or severe tricuspid regurgitation was observed. Our study suggested that using of the improved PDA occluder for the transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae is a safe and promising treatment option.