J Med Assoc Thai 2003; 86 (10):911

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Transcatheter Closure of Perimembranous Ventricular Septal Defect with Immediate Follow-up
Durongpisitkul K Mail, Soongswang J , Laohaprasitipom D , Nana A , T

JARUPIM SOONGSWANG, MD*,
API CHART NANA, MD*,
Background : Surgical closure of membranous ventricular septal defect (VSD) is performed
by open heart surgery with a small but significant morbidity and mortality. The authors reported here
the first group of patients who underwent transcatheter closure of membranous VSD.
Method : Patients who had membranous VSD with significant left to right shunt as shown
by echocardiogram were selected for closure. A standard right and left heart catheterization was done
under general anesthesia. A complete arteriovenous wire loop from the aorta to the left ventricle and
VSD out into right ventricle was formed in order to guide the delivery sheath into the VSD from the
right ventricle. The authors used the new Amplatzer'" Membranous VSD Occluder (AGA Medical Corp.,
USA) to deploy in the VSD position.
Results : There were 4 patients in the present study with age range of 2 to 24 years old
(median : 4 years old). Their weight ranged from 10 to 45 kg (median : 12 kg). Qp:Qs ranged from
1.7-2.5 to
l.
The device diameter selected was from 6 to 10 mm. All of them were placed without any
residual shunt. At one month follow-up all the patients had echocardiographic examination which
showed no evidence of residual shunt.
Conclusions : The authors demonstrated that transcatheter closure of membranous VSD could
be safely and effectively performed in small children. This device also provided an opportunity for
closure of VSD in patients with pulmonary hypertension.
Key word : Transcatheter Therapy, VSD, Cardiac Catheterization

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