Safety and efficacy of a domestic made small-waist ventricular septal defect occluder for transcatheter closure of ruptured aneurysm of the sinus of Valsalva
10.3760/cma.j.issn.0253-3758.2012.04.008
- VernacularTitle:国产细腰型室间隔缺损封堵器治疗主动脉窦瘤破裂的疗效与安全性
- Author:
Shao-Ping CHEN
1
;
Yuan BAI
;
Xian-Xian ZHAO
;
Yong-Wen QIN
Author Information
1. 第二军医大学附属长海医院
- Keywords:
Sinus of Valsalva;
Heart catheterization;
Treatment outcome
- From:
Chinese Journal of Cardiology
2012;40(4):298-301
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of transcatbeter closure of ruptured aneurysm of the sinus of Valsalva (RAVS) using a domestic made small-waist ventricular septal defect occluder.Methods Between September 2005 and December 2010,transcatheter closure of RAVS was randomly performed in 7 patients of (43.5 ± 13.0) years old using domestic made small-waist ventricular septal defect occluder in our department.RAVS was diagnosed by color Doppler echocardiography.The size of the small-waist double-disk occlude selected was 4 to 6 mm larger than the narrowest diameter of the opening of aneurysm. After establishment of the arteriovenous wire loop,the device was deployed by retrograde venous approach in all patients.All patients were followed up in terms of rhythm change,residual shunt,shape of occlude,and possible valve regurgitation by echocardiography for 6 to 12 months.Results All RAVS were confirmed by aortography.Aortography showed rupture of right coronary sinus into the right ventricle in 6 patients and non-coronary sinus ruptured into right ventricle in another patient.The estimated size of the defect was 4 to 7 (5.0 ± 1.3) mm by aortogram.Ventricular septal defect was evidenced in 2 patients.All defects were successfully occluded without complication.Two patients with ventricular septal defect received combined percutaneous ventricular septal defect closure.After transcatheter RAVS occlusion,pulmonary artery systolic pressure decreased from (35.6 ± 12.7)mm Hg ( 1 mm Hg =0.133 kPa) to(27.4 ±6.2) mm Hg ( P＜0.05 ),and mean pulmonary artery pressure decreased from ( 21.9 ± 8.0 )mm Hg to ( 16.1 ± 5.3 )mm Hg ( P＜ 0.05 ). Cardiac murmur disappeared right after successful occlusion.Echocardiography detected a trace of residual shunt in one patient after occlusion which disappeared the next day.There was no aortic regurgitation,hemolysis and arrhythmia during hospitalization.There was no device embolization,infective endocarditis,right heart failure and death during the 6 to 12 months followup.Conclusion Transcatheter closure of RAVS with the domestic made small-waist ventricular septal defect occluder is safe and effective.
