The clinical application of Amplatzer duct occluder Ⅱ in treating perimembranous ventricular septal defects

Objective: To discuss the feasibility of using Amplatzer duct occluder Ⅱ to treat perimembranous ventricular septal defects. Methods: Transcatheter closure by using Amplatzer duct occluder Ⅱ was carried out in two female infants with small perimembranous ventricular septal defect. One female infant was 3 years old. The echocardiogram showed that the diameter of VSD was 5.5 mm in left ventricle side and 2.3 mm in right ventricle side. The distance of the upper border of VSD to aortic valve was 4 mm. The other female infant was 2 years and 10 months old, the diameter of VSD was 7.8 mm in left ventricle side and 2.0 mm in right ventricle side. The distance between the upper border of VSD to aortic valve was 5.8 mm. Results: For one infant the 4 by 4 mm Amplatzer duct occluder Ⅱ and 5 F TorqVue low profile delivery catheter was employed, while for the other infant 3 by 4 mm Amplatzer duct occluder Ⅱ and 4 F delivery catheter was used. In accordance with the standard procedure the arteriovenous pathway was set up first, than the left shed and right shed were released in turn. After the operation, echocardiogram showed that there was no residual shunt and aortic regurgitation in occluded site, but mild atrioventricular regurgitation was seen in one infant. The electrocardiogram performed two days after procedure was normal. Conclusion: Transcatheter closure by using Amplatzer duct occluder Ⅱ is very effective for the treatment of small perimembranous ventricular septal defects in infants. This technique has some advantages such as the use of small delivery catheter, minimally-invasive to the vessels, etc. In a short-term after the operation no complications such as residual shunt, valve regurgitation, arrhythmia, etc. occur. (authors)