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European Heart Journal Advance Access published online on October 19, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl340
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received January 30, 2006
Revised September 19, 2006
Accepted October 5, 2006

Clinical research

Percutaneous closure of ventricular septal defects in children aged <12: early and mid-term results

Gianfranco Butera 1 *, Mario Carminati 1, Massimo Chessa 1, Luciane Piazza 1, Raul Abella 1, Diana Gabriella Negura 1, Alessandro Giamberti 1, Bussadori Claudio 1, Angelo Micheletti 1, Youssef Tammam 1, and Alessandro Frigiola 1

1 Department of Pediatric Cardiology and Cardiac Surgery, Istituto Policlinico San Donato, Via Morandi, 30, 20097 San Donato Milanese, Italy

* To whom correspondence should be addressed.
Gianfranco Butera, E-mail: gianfra.but{at}lycos.com


  Abstract

Aims The aim of the article is to study the safety, efficacy, and follow-up of percutaneous closure of muscular ventricular septal defect (mVSD) and perimembranous ventricular septal defect (pmVSD) in children.

Methods and results Between January 2000 and June 2005, among 140 patients who underwent percutaneous closure of an mVSD or a pmVSD, 88 were aged lt;12. Two different Amplatzer devices were used: the mVSD occluder and the pmVSD occluder. Mean age and weight at procedure were 4.5 ± 3.3 years and 18.7 ± 11.2 kg, respectively. Percutaneous closure was successfully achieved in 83 subjects (94%). No deaths occurred. Thirteen patients (14.7%) had early complications: device embolization (n = 4), vascular complications (n = 3), and rhythm abnormalities (n = 6). These were transient complications in all but one case [1.1% complete atrioventricular block (cAVB) needing pacemaker implantation]. During a median follow-up of 24 months, three subjects treated for a pmVSD needed pacemaker implantation due to the occurrence of cAVB. Multivariable analysis using Cox's proportional hazard regression showed that age was the only risk factor associated with the occurrence of cAVB (P = 0.028; relative risk: 0.25).

Conclusion Percutaneous closure of mVSD and pmVSD in children can be performed safely and successfully. The occurrence of cAVB is a major concern in young children with pmVSD.

Keywords: Septal defect; Children; Treatment; Percutaneous.
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