Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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The hybrid perventricular closure of apical muscular ventricular septal defect with Amplatzer duct occluder

  • Kim, Soo Jin (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Huh, June (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Song, Jin Young (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yang, Ji-Hyuk (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jun, Tae-Gook (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, I-Seok (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2013.08.23
  • 심사 : 2012.10.24
  • 발행 : 2013.04.15
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초록

Purpose: Apical muscular ventricular septal defects (MVSDs), especially in small infants, can be difficult to manage using surgical and percutaneous closure. An intraoperative perventricular procedure is a good option for closing apical MVSDs in small children with or without associated cardiac anomalies. We evaluated the results of hybrid perventricular closure of apical MVSDs performed using an Amplatzer duct occluder (ADO). Methods: We retrospectively reviewed the medical records of 5 patients who underwent hybrid perventricular closure of MVSDs with ADOs, from March 2006 to May 2011. The median patient age at the time of the procedure was 12 months (range, 25 days to 25 months), and the median body weight was 9.1 kg (range, 4.3 to 15 kg). Two patients had multiple ventricular septal defects (VSDs; additional perimembranous VSD in 1 patient and multiple MVSDs in the other) and 3 patients had associated cardiac anomalies; complete transposition of the great arteries in 1 patient and an atrial septal defect in 2 patients. All the procedures were performed on beating hearts, exception in 1 case. The ADO selected for the aortic side was at least 1 to 2 mm larger than the largest VSD in the left ventricle side. Results: The procedure was successful in all patients and each device was well positioned. During the median follow-up of 2.4 years, a small residual VSD was noted in 2 patients who had multiple VSDs and no leakage was seen in the other 3 patients. Conclusion: Perventricular closure of MVSD with an ADO is a good option for patients with apical MVSD. However, careful manipulation is important, especially in the case of small infants.

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참고문헌

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  1. Perventricular Device Closure of Congenital Ventricular Septal Defects vol.29, pp.3, 2013, https://doi.org/10.1111/jocs.12334
  2. Longer‐term outcome of perventricular device closure of muscular ventricular septal defects in children vol.85, pp.6, 2013, https://doi.org/10.1002/ccd.25821
  3. Transthoracic Balloon Pulmonary Valvuloplasty for Treatment of Congenial Pulmonary Atresia Patients with Intact Ventricular Septum vol.23, pp.None, 2013, https://doi.org/10.12659/msm.904043
  4. Outcomes Associated with the Off-label Use of Medical Devices in Congenital Heart Disease at a Single Institute vol.47, pp.4, 2017, https://doi.org/10.4070/kcj.2016.0311
  5. Effects of transthoracic device closure on ventricular septal defects and reasons for conversion to open-heart surgery: A meta-analysis vol.7, pp.None, 2013, https://doi.org/10.1038/s41598-017-12500-6
  6. Arterial switch procedure and hybrid muscular ventricular septal defect closure in a patient with d-transposition of the great arteries and multiple ventricular septal defects: a case report and liter vol.29, pp.12, 2019, https://doi.org/10.1017/s1047951119002300