Key result
Transesophageal echocardiography-guided percutaneous closure of multiple muscular ventricular septal defects using a single device successfully reduced the tricuspid valve gradient to 18 mmHg at 1.5 years.
Why the study?
Challenging ventricular septal defects with pulmonary hypertension and multiple defects typically require surgery, motivating evaluation of percutaneous closure with a single device using a zero-fluoroscopy technique.
Case Report (n=1)
No
Percutaneous closure of multiple muscular VSDs with a single device using a zero-fluoroscopy, TEE-guided transjugular approach is feasible and effective, even in the presence of pulmonary hypertension.
May support single-device percutaneous closure in select cases; hypothesis-generating and should not yet change practice.
Background: Surgery is typically used to correct challenging ventricular septal defects (VSDs), such as VSD with pulmonary hypertension and multiple defects. In this case report, we would like to highlight the feasibility of multiple defects VSD closure with single device percutaneously using zero-fluoroscopy technique. Case presentation: A 7-year-old child was referred with the main symptom of shortness of breath. She started experiencing repeated respiratory tract infections, feeding issues, and failure to thrive at the age of six months. Her body weight was only 18 kg. TEE revealed several muscular VSD with 2-3 mm and 12 mm diameters, 3 mm spacing between VSD, L to R shunt, AR (-), and TR mild with septal leaflet tricuspid prolapse. Following right heart catheterization (Qp:Qs 3.5, PVRi 5.23WUmsq, PVR 4.55 WU, PVR/SVR 0.16), we made the decision to correct the defect using an Amplatzer Septal Occluder (AGA) No. 16 mm using transjugular method. Full device deployment was successfully performed with several episodes of PVC storm and severe bradycardia. One and a half years after the procedure, her TVG dropped to only 18 mmHg, her visible indicators of PH subsided, and the PA dilator treatment was discontinued. Her body weight had increased to 28 kg, and she had no complaints. Conclusions: Our experience demonstrated that percutaneous closure of multiple VSD with a single device is possible, even with pulmonary hypertension.
No takes yet. Share an insight, caveat, or question.
Siagian et al. (2023) conducted a case report in Multiple muscular ventricular septal defects with pulmonary hypertension (n=1). Transesophageal echocardiography-guided percutaneous closure with a single Amplatzer Septal Occluder was evaluated on Successful device deployment and reduction in tricuspid valve gradient (TVG). Transesophageal echocardiography-guided percutaneous closure of multiple muscular ventricular septal defects using a single device successfully reduced the tricuspid valve gradient to 18 mmHg at 1.5 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: