Acute and midterm results following perventricular device closure of muscular ventricular septal defects

A multicenter PICES investigation

Robert G. Gray, Shaji C. Menon, Joyce T. Johnson, Aimee K. Armstrong, Michael A. Bingler, John P. Breinholt, Damien Kenny, John Lozier, Joshua J. Murphy, Shyam Sathanandam, Nathaniel W. Taggart, Sara M. Trucco, Bryan H. Goldstein, Brent M. Gordon

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To describe acute and mid-term results of hybrid perventricular device closure of muscular ventricular septal defects (mVSDs). Background: Perventricular device closure of mVSDs can mitigate technical limitations of percutaneous closure and need for cardiopulmonary bypass or ventriculotomy with a surgical approach. Methods: This is a multicenter retrospective cohort study of patients undergoing hybrid perventricular mVSD device closure from 1/2004 to 1/2014. Procedural details, adverse events, outcomes, and follow-up data were collected. Patients were divided into two groups: (1) simple (mVSD closure alone) and (2) complex (mVSD closure with concomitant cardiac surgery). Results: Forty-seven patients (60% female) underwent perventricular mVSD device closure at a median age of 5.2 months (IQR 1.8–8.9) and weight of 5.1 kg (IQR 4.0–6.9). Procedural success was 91% [100% (n = 22) simple and 84% (n = 21/25) complex]. Adverse events occurred in 19% (9/47) [9% (2/22) simple and 28% (7/25) complex]. Hospital length of stay (LOS) was shorter in the simple vs. complex group (4 vs. 14 days, P < 0.01). At mid-term follow-up of 19.2 months (IQR 2.3–43) 90% of pts had complete mVSD closure; none developed late heart block, increased atrioventricular (AV) valve insufficiency or ventricular dysfunction. Conclusions: Perventricular device closure of simple mVSD was associated with a high rate of procedural success, few adverse events, and short hospital LOS. Procedural adverse events were associated with the presence of concomitant complex surgery. Residual mVSD, AV valve insufficiency, or ventricular dysfunction were uncommon at mid-term follow-up.

Original languageEnglish (US)
Pages (from-to)281-289
Number of pages9
JournalCatheterization and Cardiovascular Interventions
Volume90
Issue number2
DOIs
StatePublished - Aug 1 2017

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Ventricular Heart Septal Defects
Equipment and Supplies
Length of Stay
Ventricular Dysfunction
Heart Block
Cardiopulmonary Bypass
Thoracic Surgery
Cohort Studies
Retrospective Studies
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Acute and midterm results following perventricular device closure of muscular ventricular septal defects : A multicenter PICES investigation. / Gray, Robert G.; Menon, Shaji C.; Johnson, Joyce T.; Armstrong, Aimee K.; Bingler, Michael A.; Breinholt, John P.; Kenny, Damien; Lozier, John; Murphy, Joshua J.; Sathanandam, Shyam; Taggart, Nathaniel W.; Trucco, Sara M.; Goldstein, Bryan H.; Gordon, Brent M.

In: Catheterization and Cardiovascular Interventions, Vol. 90, No. 2, 01.08.2017, p. 281-289.

Research output: Contribution to journalArticle

Gray, RG, Menon, SC, Johnson, JT, Armstrong, AK, Bingler, MA, Breinholt, JP, Kenny, D, Lozier, J, Murphy, JJ, Sathanandam, S, Taggart, NW, Trucco, SM, Goldstein, BH & Gordon, BM 2017, 'Acute and midterm results following perventricular device closure of muscular ventricular septal defects: A multicenter PICES investigation', Catheterization and Cardiovascular Interventions, vol. 90, no. 2, pp. 281-289. https://doi.org/10.1002/ccd.27121
Gray, Robert G. ; Menon, Shaji C. ; Johnson, Joyce T. ; Armstrong, Aimee K. ; Bingler, Michael A. ; Breinholt, John P. ; Kenny, Damien ; Lozier, John ; Murphy, Joshua J. ; Sathanandam, Shyam ; Taggart, Nathaniel W. ; Trucco, Sara M. ; Goldstein, Bryan H. ; Gordon, Brent M. / Acute and midterm results following perventricular device closure of muscular ventricular septal defects : A multicenter PICES investigation. In: Catheterization and Cardiovascular Interventions. 2017 ; Vol. 90, No. 2. pp. 281-289.
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abstract = "Objectives: To describe acute and mid-term results of hybrid perventricular device closure of muscular ventricular septal defects (mVSDs). Background: Perventricular device closure of mVSDs can mitigate technical limitations of percutaneous closure and need for cardiopulmonary bypass or ventriculotomy with a surgical approach. Methods: This is a multicenter retrospective cohort study of patients undergoing hybrid perventricular mVSD device closure from 1/2004 to 1/2014. Procedural details, adverse events, outcomes, and follow-up data were collected. Patients were divided into two groups: (1) simple (mVSD closure alone) and (2) complex (mVSD closure with concomitant cardiac surgery). Results: Forty-seven patients (60{\%} female) underwent perventricular mVSD device closure at a median age of 5.2 months (IQR 1.8–8.9) and weight of 5.1 kg (IQR 4.0–6.9). Procedural success was 91{\%} [100{\%} (n = 22) simple and 84{\%} (n = 21/25) complex]. Adverse events occurred in 19{\%} (9/47) [9{\%} (2/22) simple and 28{\%} (7/25) complex]. Hospital length of stay (LOS) was shorter in the simple vs. complex group (4 vs. 14 days, P < 0.01). At mid-term follow-up of 19.2 months (IQR 2.3–43) 90{\%} of pts had complete mVSD closure; none developed late heart block, increased atrioventricular (AV) valve insufficiency or ventricular dysfunction. Conclusions: Perventricular device closure of simple mVSD was associated with a high rate of procedural success, few adverse events, and short hospital LOS. Procedural adverse events were associated with the presence of concomitant complex surgery. Residual mVSD, AV valve insufficiency, or ventricular dysfunction were uncommon at mid-term follow-up.",
author = "Gray, {Robert G.} and Menon, {Shaji C.} and Johnson, {Joyce T.} and Armstrong, {Aimee K.} and Bingler, {Michael A.} and Breinholt, {John P.} and Damien Kenny and John Lozier and Murphy, {Joshua J.} and Shyam Sathanandam and Taggart, {Nathaniel W.} and Trucco, {Sara M.} and Goldstein, {Bryan H.} and Gordon, {Brent M.}",
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T1 - Acute and midterm results following perventricular device closure of muscular ventricular septal defects

T2 - A multicenter PICES investigation

AU - Gray, Robert G.

AU - Menon, Shaji C.

AU - Johnson, Joyce T.

AU - Armstrong, Aimee K.

AU - Bingler, Michael A.

AU - Breinholt, John P.

AU - Kenny, Damien

AU - Lozier, John

AU - Murphy, Joshua J.

AU - Sathanandam, Shyam

AU - Taggart, Nathaniel W.

AU - Trucco, Sara M.

AU - Goldstein, Bryan H.

AU - Gordon, Brent M.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objectives: To describe acute and mid-term results of hybrid perventricular device closure of muscular ventricular septal defects (mVSDs). Background: Perventricular device closure of mVSDs can mitigate technical limitations of percutaneous closure and need for cardiopulmonary bypass or ventriculotomy with a surgical approach. Methods: This is a multicenter retrospective cohort study of patients undergoing hybrid perventricular mVSD device closure from 1/2004 to 1/2014. Procedural details, adverse events, outcomes, and follow-up data were collected. Patients were divided into two groups: (1) simple (mVSD closure alone) and (2) complex (mVSD closure with concomitant cardiac surgery). Results: Forty-seven patients (60% female) underwent perventricular mVSD device closure at a median age of 5.2 months (IQR 1.8–8.9) and weight of 5.1 kg (IQR 4.0–6.9). Procedural success was 91% [100% (n = 22) simple and 84% (n = 21/25) complex]. Adverse events occurred in 19% (9/47) [9% (2/22) simple and 28% (7/25) complex]. Hospital length of stay (LOS) was shorter in the simple vs. complex group (4 vs. 14 days, P < 0.01). At mid-term follow-up of 19.2 months (IQR 2.3–43) 90% of pts had complete mVSD closure; none developed late heart block, increased atrioventricular (AV) valve insufficiency or ventricular dysfunction. Conclusions: Perventricular device closure of simple mVSD was associated with a high rate of procedural success, few adverse events, and short hospital LOS. Procedural adverse events were associated with the presence of concomitant complex surgery. Residual mVSD, AV valve insufficiency, or ventricular dysfunction were uncommon at mid-term follow-up.

AB - Objectives: To describe acute and mid-term results of hybrid perventricular device closure of muscular ventricular septal defects (mVSDs). Background: Perventricular device closure of mVSDs can mitigate technical limitations of percutaneous closure and need for cardiopulmonary bypass or ventriculotomy with a surgical approach. Methods: This is a multicenter retrospective cohort study of patients undergoing hybrid perventricular mVSD device closure from 1/2004 to 1/2014. Procedural details, adverse events, outcomes, and follow-up data were collected. Patients were divided into two groups: (1) simple (mVSD closure alone) and (2) complex (mVSD closure with concomitant cardiac surgery). Results: Forty-seven patients (60% female) underwent perventricular mVSD device closure at a median age of 5.2 months (IQR 1.8–8.9) and weight of 5.1 kg (IQR 4.0–6.9). Procedural success was 91% [100% (n = 22) simple and 84% (n = 21/25) complex]. Adverse events occurred in 19% (9/47) [9% (2/22) simple and 28% (7/25) complex]. Hospital length of stay (LOS) was shorter in the simple vs. complex group (4 vs. 14 days, P < 0.01). At mid-term follow-up of 19.2 months (IQR 2.3–43) 90% of pts had complete mVSD closure; none developed late heart block, increased atrioventricular (AV) valve insufficiency or ventricular dysfunction. Conclusions: Perventricular device closure of simple mVSD was associated with a high rate of procedural success, few adverse events, and short hospital LOS. Procedural adverse events were associated with the presence of concomitant complex surgery. Residual mVSD, AV valve insufficiency, or ventricular dysfunction were uncommon at mid-term follow-up.

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