TRANSCATHETER OCCLUSION OF ANEURYSMAL SUBAORTIC VENTRICULAR SEPTAL DEFECTS BY MEANS OF NIT-OCCLUD (PFM) DETACHABLE COILSPRIMARY EXPERIENCE IN A TERTIARY CENTER

Abstract

Objective: To share a single centre experience of transcatheter device closure of subaortic aneurysmal ventricular septal defects with Nit-Occlud (PFM) detachable Coils at a tertiary cardiac center in Pakistan.

Study Design: A retrospective case series study.

Place and Duration of Study: AFIC/NIHD Rawalpindi Pakistan, from Jun 2018 to Oct 2018.

Material and Methods: A retrospective analysis of all consecutive patients had percutaneous occlusion of aneurysmal sub aortic perimembranous VSD with Nit-Occlud (PFM) detachable Coils was carried out to assess its immediate and short term efficacy and safety.

Results: 12 patients (pts) had aneurysmal per-membranous (PM) VSD were enrolled. In 11 patients successful VSD closure was performed. Mean age of patients was 8 ± 5.7 years. Mean procedural time was 52.69 ± 12 mins. Total fluoroscopy time was 15 ± 8.5 min. Contrast had meant of 54 ± 19.6 ml. 5 were males and 7 patients were females (M:F, 0.8:1). 4 pt’s (36.3%) had mild to moderate residual shunts. Closure rate was 81.8% after 1 and 4 months. Onept’s had immediate device retrieval, 2 (18.1%) had transient IV hemolysis and 2 (18.1%) had persistent severe IV hemolysis. None of our patients had heart blocks, device embolisation or infective endocarditis during a mean follow-up period of 2 months (range1 to 4 months).

Conclusion: In selected cases VSD closure with Nit-Occlud detachable Coils is safe and feasible with a minimal risk of side effects like heart block. Close monitoring is needed for intravascular hemolysis in patients having residual shunts in the immediate post procedure period.