Pediatric Cardiology

, Volume 27, Issue 6, pp 720–728

Retrograde Approach for Device Closure of Muscular Ventricular Septal Defects in Children and Adolescents, Using the Amplatzer Muscular Ventricular Septal Defect Occluder

  • Al-Ata Jameel
  • Amin Muhammed Arfi
  • Hussain Arif
  • Kouatli Amjad
  • Galal Mohammed Omar
ORIGINAL ARTICLE

DOI: 10.1007/s00246-006-1365-5

Cite this article as:
Jameel, AA., Arfi, A.M., Arif, H. et al. Pediatr Cardiol (2006) 27: 720. doi:10.1007/s00246-006-1365-5

Abstract

This study presents technique and initial experience of retrograde deployment of the Amplatzer muscular ventricular septal defect occluder (AmVSDo) for closure of muscular ventricular septal defects (VSDs). The conventional technique for closing muscular VSDs involves the creation of an arteriovenous guidewire circuit and use of a transvenous approach for device deployment. Seven patients aged 2.2–15 years underwent transcatheter closure of a muscular VSD using the retrograde approach without making the arteriovenous wire circuit. Mean fluoroscopy and procedural times were compared to those previously reported in publications describing the use of the antegrade approach. Unpaired Student’s t-test was used to compare the two parameters in two groups. Our technique was successful in all patients reported. The mean fluoroscopy time in the retrograde versus the antegrade group was 33.8 ± 20.9 and 41.9 ± 6.2 minutes, respectively (not significant), and the mean procedural time in the two groups was 91.1 ± 22.1 and 114 ± 33.9 minutes respectively (p = 0.025). No complications were noted.

We suggest that some muscular VSDs can be safely closed retrogradely without the use of an arteriovenous loop, thus reducing the radiation exposure and also the cost of the procedure. Further studies are needed to confirm this initial experience.

Keywords

Transcatheter closure Percutaneous device occlusion Cardiac catheterization 

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Al-Ata Jameel
    • 1
  • Amin Muhammed Arfi
    • 1
  • Hussain Arif
    • 1
  • Kouatli Amjad
    • 1
  • Galal Mohammed Omar
    • 1
    • 2
  1. 1.Section of Pediatric Cardiology, Department of Cardiovascular DiseasesKing Faisal Specialist Hospital & Research Center, JeddahJeddahSaudi Arabia
  2. 2.University of Pediatric Hospital EssenEssenGermany