Nazmi NARİN, Abdullah ÖZYURT, Özge PAMUKÇU, Kazım ÜZÜM, Sadettin SEZER, Sertaç H. ONAN, Gökmen ZARASIZ, Mustafa ARGUN, Ali BAYKAN

Tek bir merkezin transkateter ventriküler septal defekt kapatma sonuçları

Amaç: Bu çalışmada ventriküler septal defektlerin (VSD) perkütan kapatılmasının güvenilirliği, etkinliği ve ortauzun dönem takip sonuçları araştırıldı.Çalışma planı: Eylül 2006 - Nisan 2013 tarihleri arasında tek bir merkezde transkateter VSD kapatılması uygulanan 53 hastanın (30 erkek, 23 kız; ort. yaş 6.5 yıl; dağılım 3-19 yıl) verileri retrospektif olarak incelendi. Çalışmaya transkateter kapatılma için uygun, hemodinamik olarak anlamlı perimembranöz (n=42) ve musküler (n=11) VSD'ler dahil edildi. Çalışmada dört farklı cihaz kullanıldı: perimembranöz Amplatzer VSD oklüder, musküler Amplatzer VSD oklüder, duktal Amplatzer oklüder I ve II.Bul gu lar: Ortanca vücut ağırlığı 21.5 kg (dağılım 13-87 kg) idi. Başarılı kapatma oranı %92 idi. Bir hasta işlemden beş gün sonra tam atriyoventriküler blok nedeniyle ve bir hasta da işlemden bir gün sonra beyin kanaması nedeniyle öldü.So nuç: Ventriküler septal defektlerin transkateter kapatılması seçilmiş olgularda etkin bir yöntemdir. Bununla birlikte, tam atriyoventriküler blok oluşumu bu işlemde önemli bir sorundur. Perimembranöz VSD'de cerrahi ilk tedavi seçeneği olarak düşünülmelidir. Öte yandan, olası komplikasyonlara karşı gerekli önlemler alındığında, transkateter yaklaşım seçilmiş olgularda defektin kapatılması için kullanılabilir.

Single-center results of the use of transcatheter closure for ventricular septal defects

Background: This study aims to investigate the safety, efficacy, and mid- to long-term follow-up results of percutaneous closure of ventricular septal defects (VSD).Methods: The data of 53 patients (30 boys, 23 girls; median age 6.5 years; range 3 to 19 years) who were performed transcatheter closure of VSD between September 2006 and April 2013 in a single center were retrospectively analyzed. Perimembranous (n=42) and muscular (n=11) VSDs with hemodynamic significance which were suitable for transcatheter closure were included in the study. Four different devices were used in the study: the perimembranous Amplatzer VSD occluder, muscular Amplatzer VSD occluder, ductal Amplatzer occluder I, and II.Results: Median body weight was 21.5 kg (range 13 to 87 kg). The ratio of successful closure was 92%. One patient died due to complete atrioventricular block five days after the procedure and one patient died due to cerebral hemorrhage one day after the procedure.Conclusion: Transcatheter closure of VSDs is an efficient method in selective cases. However, occurrence of complete atrioventricular block is a major concern in this procedure. Surgery should be considered as the first treatment choice in perimembranous VSD. However, in selected patients, transcatheter approach can be used for defect closure when necessary measures are taken against possible complications.

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