Skip to main content
Erschienen in: Pediatric Cardiology 1/2024

11.12.2023 | Research

Transcatheter Ventricular Septal Defect Closure with Lifetech™ Konar-MF Occluder in Infants Under 10 kg with Only Using Venous Access

verfasst von: İbrahim Ece, Denizhan Bağrul, Ahmet Vedat Kavurt, Harun Terin, Gülşah Torun, Serhat Koca, Ayşe Esin Kibar Gül

Erschienen in: Pediatric Cardiology | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Transcatheter closure of VSD remains a complex procedure in infants with technical challenges and carries the risk of significant complications, due to its complex anatomical morphology and closed proximity to the atrioventricular valves and the conduction system. In this article, we presented transcatheter VSD closure in infants under 10 kg using the Lifetech Konar-MF device via only venous route without TEE guidance and arterial access. Between January 2021 and May 2023, a total of 34 patients weighing less than 10 kg who underwent transcatheter VSD closure antegradely with Lifetech™ Konar-Multifunctional (MF) occluder were included in the study. The mean age of the patients was 8.1 (3.5–35) months. Average weight was 6.5 kg (range 4.5–10 kg). VSD was perimembranous in 27 patients (79.4%). Successful device placement was achieved in all 34 patients. However, device embolization occurred in three patients. One of the patients was successfully implanted with a one size larger device, the surgical closure was performed other two cases. TR occurred in seven patients (20.6%) after releasing devices. None of the patients developed complete heart block. Right bundle branch block developed in two patients. Residual shunt was observed in 9 patients (six small, two moderate, and one large). During follow-up, residual shunt disappeared in six of these patients and only mild residual shunt remained in the other four patients which have not required any further intervention. Transcatheter closure of VSD with Lifetech Konar-MF device is safe and effective in infants less than 10 kg via only venous access with a high success rate and low complication rate. In these patients, transcatheter VSD closure can be performed by excluding the risk of complications that may occur due to AV loop formation, arterial intervention, endotracheal intubation and TEE use.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Hoffman J, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol 39(12):1890–1900CrossRefPubMed Hoffman J, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol 39(12):1890–1900CrossRefPubMed
2.
Zurück zum Zitat Morray BH (2019) Ventricular septal defect closure devices, techniques, and outcomes. Interv Cardiol Clin 8(1):1–10PubMed Morray BH (2019) Ventricular septal defect closure devices, techniques, and outcomes. Interv Cardiol Clin 8(1):1–10PubMed
3.
Zurück zum Zitat Zhao LJ, Han B, Zhang JJ, Yi YC, Jiang DD, Lyu JL (2018) Transcatheter closure of congenital perimembranous ventricular septal defect using the Amplatzer duct occluder 2. Cardiol Young 28(3):447–453CrossRefPubMed Zhao LJ, Han B, Zhang JJ, Yi YC, Jiang DD, Lyu JL (2018) Transcatheter closure of congenital perimembranous ventricular septal defect using the Amplatzer duct occluder 2. Cardiol Young 28(3):447–453CrossRefPubMed
4.
Zurück zum Zitat Santhanam H, Yang L, Chen Z, Tai BC, Rajgor DD, Quek SC (2018) A meta-analysis of transcatheter device closure of perimembranous ventricular septal defect. Int J Cardiol 254:75–83CrossRefPubMed Santhanam H, Yang L, Chen Z, Tai BC, Rajgor DD, Quek SC (2018) A meta-analysis of transcatheter device closure of perimembranous ventricular septal defect. Int J Cardiol 254:75–83CrossRefPubMed
5.
Zurück zum Zitat Hong ZN, Chen Q, Huang LQ, Cao H (2019) A meta-analysis of per- ventricular device closure of perimembranous ventricular septal defect. J Cardiothorac Surg 14(1):119CrossRefPubMedPubMedCentral Hong ZN, Chen Q, Huang LQ, Cao H (2019) A meta-analysis of per- ventricular device closure of perimembranous ventricular septal defect. J Cardiothorac Surg 14(1):119CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Yang L, Tai BC, Khin LW, Quek SC (2014) A systematic review on the efficacy and safety of transcatheter device closure of ventricular septal defects (VSD). J Interv Cardiol 27(3):260–272CrossRefPubMed Yang L, Tai BC, Khin LW, Quek SC (2014) A systematic review on the efficacy and safety of transcatheter device closure of ventricular septal defects (VSD). J Interv Cardiol 27(3):260–272CrossRefPubMed
7.
Zurück zum Zitat Haddad RN, Daou L, Saliba Z (2019) Device closure of perimembranous ventricular septal defect: choosing between amplatzer occluders. Front Pediatr 7:300CrossRefPubMedPubMedCentral Haddad RN, Daou L, Saliba Z (2019) Device closure of perimembranous ventricular septal defect: choosing between amplatzer occluders. Front Pediatr 7:300CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Holzer R, de Giovanni J, Walsh KP, Tometzki A, Goh T, Hakim F, Zabal C, de Lezo JS, Cao QL, Hijazi ZM (2006) Transcatheter closure of perimembranous ventricular septal defects using the amplatzer membranous VSD occluder: immediate and midterm results of an international registry. Catheter Cardiovasc Interv 68(4):620–628CrossRefPubMed Holzer R, de Giovanni J, Walsh KP, Tometzki A, Goh T, Hakim F, Zabal C, de Lezo JS, Cao QL, Hijazi ZM (2006) Transcatheter closure of perimembranous ventricular septal defects using the amplatzer membranous VSD occluder: immediate and midterm results of an international registry. Catheter Cardiovasc Interv 68(4):620–628CrossRefPubMed
9.
Zurück zum Zitat Zuo J, Xie J, Yi W, Yang J, Zhang J, Li J, Yi D (2010) Results of transcatheter closure of perimembranous ventricular septal defect. Am J Cardiol 106(7):1034–1037CrossRefPubMed Zuo J, Xie J, Yi W, Yang J, Zhang J, Li J, Yi D (2010) Results of transcatheter closure of perimembranous ventricular septal defect. Am J Cardiol 106(7):1034–1037CrossRefPubMed
10.
Zurück zum Zitat Hammon JW Jr (1995) Myocardial protection in the immature heart. Ann Thorac Surg 60(3):839–842CrossRefPubMed Hammon JW Jr (1995) Myocardial protection in the immature heart. Ann Thorac Surg 60(3):839–842CrossRefPubMed
11.
Zurück zum Zitat Qin Y, Chen J, Zhao X, Liao D, Mu R, Wang S, Wu H, Guo H (2008) Transcatheter closure of perimembranous ventricular septal defect using a modified double-disk occluder. Am J Cardiol 101(12):1781–1786CrossRefPubMed Qin Y, Chen J, Zhao X, Liao D, Mu R, Wang S, Wu H, Guo H (2008) Transcatheter closure of perimembranous ventricular septal defect using a modified double-disk occluder. Am J Cardiol 101(12):1781–1786CrossRefPubMed
12.
Zurück zum Zitat Saurav A, Kaushik M, Mahesh Alla V, White MD, Satpathy R, Lanspa T, Mooss AN, DelCore MG (2015) Comparison of percutaneous device closure versus surgical closure of peri-membranous ven- tricular septal defects: a systematic review and meta-analysis. Catheter Cardiovasc Interv 86(6):1048–1056CrossRefPubMed Saurav A, Kaushik M, Mahesh Alla V, White MD, Satpathy R, Lanspa T, Mooss AN, DelCore MG (2015) Comparison of percutaneous device closure versus surgical closure of peri-membranous ven- tricular septal defects: a systematic review and meta-analysis. Catheter Cardiovasc Interv 86(6):1048–1056CrossRefPubMed
13.
Zurück zum Zitat Lock JE, Block PC, McKay RG, Baim DS, Keane JF (1988) Transcatheter closure of ventricular septal defects. Circulation 78(2):361–368CrossRefPubMed Lock JE, Block PC, McKay RG, Baim DS, Keane JF (1988) Transcatheter closure of ventricular septal defects. Circulation 78(2):361–368CrossRefPubMed
14.
Zurück zum Zitat Vitiello R, McCrindle BW, Nykanen D, Freedom RM, Benson LN (1998) Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 32(5):1433–1440CrossRefPubMed Vitiello R, McCrindle BW, Nykanen D, Freedom RM, Benson LN (1998) Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 32(5):1433–1440CrossRefPubMed
15.
Zurück zum Zitat Tadphale S, Yohannan T, Kauffmann T, Maller V, Agrawal V, Lloyd H, Waller BR, Sathanandam S (2020) Accessing femoral arteries less than 3 mm in diameter is associated with increased incidence of loss of pulse following cardiac catheterization in infants. Pediatr Cardiol 41(5):1058–1066CrossRefPubMed Tadphale S, Yohannan T, Kauffmann T, Maller V, Agrawal V, Lloyd H, Waller BR, Sathanandam S (2020) Accessing femoral arteries less than 3 mm in diameter is associated with increased incidence of loss of pulse following cardiac catheterization in infants. Pediatr Cardiol 41(5):1058–1066CrossRefPubMed
16.
Zurück zum Zitat Kulkarni S, Naidu R (2006) Vascular ultrasound imaging to study immediate postcatheterization vascular complications in children. Catheter Cardiovasc Interv 68(3):450–455CrossRefPubMed Kulkarni S, Naidu R (2006) Vascular ultrasound imaging to study immediate postcatheterization vascular complications in children. Catheter Cardiovasc Interv 68(3):450–455CrossRefPubMed
17.
Zurück zum Zitat Diab KA, Cao QL, Mora BN, Hijazi ZM (2007) Device closure of muscular ventricular septal defects in infants less than one year of age using the Amplatzer devices: feasibility and outcome. Catheter Cardiovasc Interv 70(1):90–97CrossRefPubMed Diab KA, Cao QL, Mora BN, Hijazi ZM (2007) Device closure of muscular ventricular septal defects in infants less than one year of age using the Amplatzer devices: feasibility and outcome. Catheter Cardiovasc Interv 70(1):90–97CrossRefPubMed
18.
Zurück zum Zitat Arora R, Trehan V, Kumar A, Kalra GS, Nigam M (2003) Transcatheter closure of congenital ventricular septal defects: experience with various devices. J Interv Cardiol 16(1):83–91CrossRefPubMed Arora R, Trehan V, Kumar A, Kalra GS, Nigam M (2003) Transcatheter closure of congenital ventricular septal defects: experience with various devices. J Interv Cardiol 16(1):83–91CrossRefPubMed
19.
Zurück zum Zitat Zhao PJ, Yu ZQ, Gao W, Li F, Fu LJ, Liu TL, Li Y, Zhang YQ, Huang MR, Guo Y (2012) Efficacy of the transcatheter closure of perimembranous and muscular ventricular septal defects with the Amplatzer duct occluder II. Zhonghua Xin Xue Guan Bing Za Zhi 40(10):817–820PubMed Zhao PJ, Yu ZQ, Gao W, Li F, Fu LJ, Liu TL, Li Y, Zhang YQ, Huang MR, Guo Y (2012) Efficacy of the transcatheter closure of perimembranous and muscular ventricular septal defects with the Amplatzer duct occluder II. Zhonghua Xin Xue Guan Bing Za Zhi 40(10):817–820PubMed
20.
Zurück zum Zitat Damsky Barbosa J, Alonso J, Ferrín L, Rivarola M, Lucini V et al (2019) Endovascular VSD closure with lifetech KONAR-multifunctional occluder- novel device. J Struct Heart Dis 5(6):237–247 Damsky Barbosa J, Alonso J, Ferrín L, Rivarola M, Lucini V et al (2019) Endovascular VSD closure with lifetech KONAR-multifunctional occluder- novel device. J Struct Heart Dis 5(6):237–247
21.
Zurück zum Zitat Tanidir IC, Baspinar O, Saygi M, Kervancioglu M, Guzeltas A, Odemis E (2020) Use of Lifetech™ Konar-MF, a device for both perimembranous and muscular ventricular septal defects: a multicentre study. Int J Cardiol 310:43–50CrossRefPubMed Tanidir IC, Baspinar O, Saygi M, Kervancioglu M, Guzeltas A, Odemis E (2020) Use of Lifetech™ Konar-MF, a device for both perimembranous and muscular ventricular septal defects: a multicentre study. Int J Cardiol 310:43–50CrossRefPubMed
22.
Zurück zum Zitat Mukherji A, Chattopadhyay A, Ghosh S, Mohapatra SK, De A, Singhi AK (2020) Novel use of Konar-multifunctional occluder. Cardiol Young 30(11):1722–1727CrossRefPubMed Mukherji A, Chattopadhyay A, Ghosh S, Mohapatra SK, De A, Singhi AK (2020) Novel use of Konar-multifunctional occluder. Cardiol Young 30(11):1722–1727CrossRefPubMed
23.
Zurück zum Zitat Li H, Shi Y, Zhang S, Ren Y, Rong X, Wang Z, Xia T, Wu T, Xu H, Yan Y, Zhan Y, Chu M, Wu R (2019) Short- and medium-term follow-up of transcatheter closure of perimembranous ventricular septal defects. BMC Cardiovasc Disord 19(1):222CrossRefPubMedPubMedCentral Li H, Shi Y, Zhang S, Ren Y, Rong X, Wang Z, Xia T, Wu T, Xu H, Yan Y, Zhan Y, Chu M, Wu R (2019) Short- and medium-term follow-up of transcatheter closure of perimembranous ventricular septal defects. BMC Cardiovasc Disord 19(1):222CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Yildiz K, Narin N, Ozdemir R, Oksuz S, Demircan T, Bagli S, Aktas R, Nur Kecici R, Karadeniz C (2023) Closure of transcatheter ventricular septal defect using LifetechTM Konar-MF Occluder in children weighing less than 10 kilograms: mid-term results, a tertiary single center experience. Eur Rev Med Pharmacol Sci 27(9):4053–4059PubMed Yildiz K, Narin N, Ozdemir R, Oksuz S, Demircan T, Bagli S, Aktas R, Nur Kecici R, Karadeniz C (2023) Closure of transcatheter ventricular septal defect using LifetechTM Konar-MF Occluder in children weighing less than 10 kilograms: mid-term results, a tertiary single center experience. Eur Rev Med Pharmacol Sci 27(9):4053–4059PubMed
25.
Zurück zum Zitat Roy M, Gangopadhyay D, Goyal N, Murthy S, Nandi D, Bandyopadhyay B, Dutta J (2022) Transcatheter closure of ventricular septal defects in children less than 10 kg: experience from a tertiary care referral hospital in Eastern India. Cardiol Young 32(1):48–54CrossRefPubMed Roy M, Gangopadhyay D, Goyal N, Murthy S, Nandi D, Bandyopadhyay B, Dutta J (2022) Transcatheter closure of ventricular septal defects in children less than 10 kg: experience from a tertiary care referral hospital in Eastern India. Cardiol Young 32(1):48–54CrossRefPubMed
26.
Zurück zum Zitat Mathur SK, Singh P (2009) Transoesophageal echocardiography related complications. Indian J Anaesth 53(5):567–574PubMedPubMedCentral Mathur SK, Singh P (2009) Transoesophageal echocardiography related complications. Indian J Anaesth 53(5):567–574PubMedPubMedCentral
27.
Zurück zum Zitat Min JK, Spencer KT, Furlong KT, DeCara JM, Sugeng L, Ward RP, Lang RM (2005) Clinical features of complications from transesophageal echocardiography: a single-center case series of 10,000 consecutive examinations. J Am Soc Echocardiogr 18(9):925–929CrossRefPubMed Min JK, Spencer KT, Furlong KT, DeCara JM, Sugeng L, Ward RP, Lang RM (2005) Clinical features of complications from transesophageal echocardiography: a single-center case series of 10,000 consecutive examinations. J Am Soc Echocardiogr 18(9):925–929CrossRefPubMed
28.
Zurück zum Zitat Wang S, Ouyang W, Liu Y, Zhang F, Guo G, Zhao G, Pan X (2018) Transcatheter perimembranous ventricular septal defect closure under transthoracic echocardiographic guidance without fluoroscopy. J Thorac Dis 10(9):5222–5231CrossRefPubMedPubMedCentral Wang S, Ouyang W, Liu Y, Zhang F, Guo G, Zhao G, Pan X (2018) Transcatheter perimembranous ventricular septal defect closure under transthoracic echocardiographic guidance without fluoroscopy. J Thorac Dis 10(9):5222–5231CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Carminati M, Butera G, Chessa M, De Giovanni J, Fisher G, Gewillig M, Peuster M, Piechaud JF, Santoro G, Sievert H, Spadoni I, Walsh K (2007) Investigators of the European VSD Registry. Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J 28(19):2361–2368CrossRefPubMed Carminati M, Butera G, Chessa M, De Giovanni J, Fisher G, Gewillig M, Peuster M, Piechaud JF, Santoro G, Sievert H, Spadoni I, Walsh K (2007) Investigators of the European VSD Registry. Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J 28(19):2361–2368CrossRefPubMed
30.
Zurück zum Zitat Kuswiyanto RB, Gunawijaya E, Djer MM, Noormanto RMA et al (2022) Transcatheter closure of perimembranous ventricular septal defect using the lifetech Konar-multi functional occluder: early to midterm results of the indonesian multicenter study. Glob Heart 17(1):15CrossRefPubMedPubMedCentral Kuswiyanto RB, Gunawijaya E, Djer MM, Noormanto RMA et al (2022) Transcatheter closure of perimembranous ventricular septal defect using the lifetech Konar-multi functional occluder: early to midterm results of the indonesian multicenter study. Glob Heart 17(1):15CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Haddad RN, Daou LS, Saliba ZS (2020) Percutaneous closure of restrictive-type perimembranous ventricular septal defect using the new KONAR multifunctional occluder: midterm outcomes of the first middle-eastern experience. Catheter Cardiovasc Interv 96(3):295–302CrossRef Haddad RN, Daou LS, Saliba ZS (2020) Percutaneous closure of restrictive-type perimembranous ventricular septal defect using the new KONAR multifunctional occluder: midterm outcomes of the first middle-eastern experience. Catheter Cardiovasc Interv 96(3):295–302CrossRef
Metadaten
Titel
Transcatheter Ventricular Septal Defect Closure with Lifetech™ Konar-MF Occluder in Infants Under 10 kg with Only Using Venous Access
verfasst von
İbrahim Ece
Denizhan Bağrul
Ahmet Vedat Kavurt
Harun Terin
Gülşah Torun
Serhat Koca
Ayşe Esin Kibar Gül
Publikationsdatum
11.12.2023
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 1/2024
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-023-03350-3

Weitere Artikel der Ausgabe 1/2024

Pediatric Cardiology 1/2024 Zur Ausgabe

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Vorhofflimmern bei Jüngeren gefährlicher als gedacht

06.05.2024 Vorhofflimmern Nachrichten

Immer mehr jüngere Menschen leiden unter Vorhofflimmern. Betroffene unter 65 Jahren haben viele Risikofaktoren und ein signifikant erhöhtes Sterberisiko verglichen mit Gleichaltrigen ohne die Erkrankung.

Chronisches Koronarsyndrom: Gefahr von Hospitalisierung wegen Herzinsuffizienz

06.05.2024 Herzinsuffizienz Nachrichten

Obwohl ein rezidivierender Herzinfarkt bei chronischem Koronarsyndrom wahrscheinlich die Hauptsorge sowohl der Patienten als auch der Ärzte ist, sind andere Ereignisse womöglich gefährlicher. Laut einer französischen Studie stellt eine Hospitalisation wegen Herzinsuffizienz eine größere Gefahr dar.

Das Risiko für Vorhofflimmern in der Bevölkerung steigt

02.05.2024 Vorhofflimmern Nachrichten

Das Risiko, im Lauf des Lebens an Vorhofflimmern zu erkranken, ist in den vergangenen 20 Jahren gestiegen: Laut dänischen Zahlen wird es drei von zehn Personen treffen. Das hat Folgen weit über die Schlaganfallgefährdung hinaus.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.