دورية أكاديمية
Percutaneous closure of postoperative residual ventricular septal defects, including dehiscence of surgical patches.
| العنوان: | Percutaneous closure of postoperative residual ventricular septal defects, including dehiscence of surgical patches. |
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| المؤلفون: | Abdelmohsen GA; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.; Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt., Gabel HA; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia., Al-Ata JA; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.; Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Bahaidarah SA; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia., Alkhushi NA; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.; Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Abdelsalam MH; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.; Cardiology Department, Benha University, Benha, Egypt., Bekheet SB; Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.; Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Elakaby AR; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.; Pediatric Department, Al-Azhar University, Cairo, Egypt., Zaher ZF; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia., Maghrabi KA; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia., Mashali MH; Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.; Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Dohain AM; Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.; Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt. |
| المصدر: | Cardiovascular diagnosis and therapy [Cardiovasc Diagn Ther] 2023 Aug 31; Vol. 13 (4), pp. 710-727. Date of Electronic Publication: 2023 Jun 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101601613 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2223-3652 (Print) Linking ISSN: 22233652 NLM ISO Abbreviation: Cardiovasc Diagn Ther Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: SHEUNG WAN, Hong Kong : AME Publishing Company Original Publication: Hangzhou, China : CDT Office, [2011]- |
| مستخلص: | Background: Percutaneous closure of residual ventricular septal defects (VSDs) after congenital heart surgery may provide a safer and more efficient alternative to redo surgery. This study aimed to evaluate the outcome of transcatheter closure of residual postoperative VSD. Methods: This multicenter retrospective cohort study was conducted at the tertiary care institutions of King Faisal Specialist Hospital and King Abdulaziz University Hospital, Saudi Arabia, from March 2012 to March 2022. All patients who underwent transcatheter closure of postoperative residual VSD were included. As catheter closure of VSD related to surgical patches is challenging, patients were divided into two groups. Group 1 comprised patients with VSD related to the surgical patches, while Group 2 included residual muscular VSD. Various occluders and approaches were utilized based on the patient's weight and the VSD type, size, and proximity to the cardiac valves. Demographic, echocardiographic, catheterization, and outcome data were collected and analyzed using descriptive and comparative statistics. Results: Thirty-three patients underwent 37 VSD catheter closure procedures. Twenty-two procedures were done to close residual VSD related to the surgical patch, while fifteen were done for additional muscular VSD. The median age of the patients was 3.3 years, and the interquartile range (IQR) ranged between 9 months and 7 years. The median weight was 13.1 kilograms, with an IQR of 5.1 to 16.8 kilograms. The median pulmonary to systemic flow ratio (QP/QS) was 1.6 with an IQR of 1.5 to 2.44; the median systolic pulmonary pressure was 46 mmHg with an IQR of 32 to 54 mmHg. The median procedure duration was 120 minutes, with an IQR of 90 to 160 minutes. Patients in Group 1 were older and had a lower mean pulmonary pressure than Group 2 (P=0.02, P=0.007, respectively). Of the 37 procedures, 35 (94.6%) were done successfully, while two patients had redo surgery due to failed procedures (one had device embolization). Ten successful catheterizations were performed for infants weighing ≤5 kilograms. The functional heart failure class improved significantly after the closure of the residual VSD. There were three documented mortalities, none related to the procedure. No significant difference between patient groups regarding hospital stay or survival (P=0.660, P=0.791, respectively). Conclusions: After congenital heart surgery, transcatheter closure of residual VSD may be a safe and effective alternative to surgical closure. It can be applied to various residual VSD using a variety of occluders with satisfactory results. Moreover, using specific approaches can close residual VSD, even in small infants. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-22-624/coif). The authors have no conflicts of interest to declare. (2023 Cardiovascular Diagnosis and Therapy. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: Postoperative; catheterization; closure; residual; ventricular septal defect (VSD) |
| تواريخ الأحداث: | Date Created: 20230907 Latest Revision: 20230908 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10478022 |
| DOI: | 10.21037/cdt-22-624 |
| PMID: | 37675084 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2223-3652 |
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| DOI: | 10.21037/cdt-22-624 |