Directly ventricular septal defect closure without using arteriovenous wire loop: Our adult case series using transarterial retrograde approachNihat Pekel1, Ertuğrul Ercan1, Mehmet Emre Özpelit1, Ferhat Özyurtlu2, Akar Yılmaz1, Caner Topaloğlu1, Serkan Saygı1, Serkan Yakan3, İstemihan Tengiz1
1Department of Cardiology, İzmir Medicalpark Hospital; İzmir-Turkey
2Department of Cardiology, Private Grandmedical Hospital; Manisa-Turkey
3Department of Cardiology, Private Kardiya Cardiology Branch Center; İzmir-Turkey
Objective: The standard transcatheter ventricular septal defects (VSD) closure procedure is established with arteriovenous (AV) loop and is called as antegrade approach. The directly retrograde transarterial VSD closure without using AV loop might be better option as shortens the procedure time and decreases radiation exposure.Keywords: ventricular septal defects, catheterization closure devices
Methods: Our series consist of twelve sequential adult cases with congenital VSDs (seven with perimembranous, four with muscular, one with postoperative residuel VSD). The mean age was 26.9 (Range 1858), the mean height was 168.75 cm (Range 155185cm), and the mean body mass index was 23.4 (Range 17.328.4). Maximum and minimum defect sizes were 10 and 5 mm and the mean defect size was 6.24 mm. The procedure was performed with left heart catheterization and advancing the delivery sheath over the stiff exchange wire then VSD occlusion from left side.
Results: The defects were successfully closed with this technique in eleven patients. In sixth patient, the defect could not be cannulated by the delivery sheath, as the tip of the sheath did not reach the defect and VSD was closed with same sheath by standard transvenous approach u- sing AV loop. We didnt encounter any complication releated to semilunar or atrioventricular valves. Atrioventricular conduction system was not affected by the procedure in any patients. The median procedure and fluoroscopy times were 66 and 16.5 minutes respectively.
Conclusion: Transarterial retrograde VSD closure without using AV loop simplifies the procedure, decreases the radiation exposure, and short- ens the procedure time. The only limitation in adult patients is delivery sheath length. (Anatol J Cardiol 2017; 17: 000-00)
Corresponding Author: Ertuğrul Ercan, Türkiye