Object: To report the immediate and mid-term follow-up results of the Amplatzer membranous VSD occluder for the percutaneous occlusion of the perimembranous VSD.
Background: Percutaneous perimembranous VSD occlusion is still considered an experimental method where a variety of devices have been tested. Nowadays, more than 500 membranous Amplatzer devices have been implanted worldwide with encouraging results.
Method: We included 6 patients (1 man and 5 women) with a mean age of 9.9 years (range, 3 to 17.5) in whom percutaneous perimembranous VSD closure was attempted.
Results: In one of the patients, positioning of the device was not possible (intention to treat success rate, 83.3%). In the remaining five patients, there was a single defect. The VSD mean diameter with echo was 7 +/- 1.7 mm (range, 5.1 to 9) and with angio was 6.9 +/- 1 (range, 6 to 8). Mean pulmonary pressure was 20.2 +/- 7.7 mm Hg (range, 12-30) and Qp/Qs was 1.69 +/- 0.65 (range, 1.2-2.8). A single device was use in all cases. Immediate angiographic control showed complete occlusion in two patients, trivial shunt in one, and mild shunt in two. Follow-up was at least 4 months. Only one patient has residual trivial shunt, the rest of the defects are completely closed.
Conclusion: The special design of the Amplatzer membranous VSD occluder allows percutaneous closure of this defect in a safe and effective way, with good mid-term results. In selected cases, this is a good alternative to surgery in the treatmen of this cardiac defect.