Safety and efficacy of Amplatzer duct occluder for percutaneous closure of ventricular septal defects with tunnel shape aneurysm: Medium term follow up

Objectives: Different devices including Amplatzer duct occluder has been used for percutaneous closure of ventricular septal defects. This study reports our medium term follow up of perimembranous and muscular ventricular septal defects with tunnel shape aneurysm closure using the Amplatzer duct occluder. Materials and Methods: From May 2006-December 2012, we used Amplatzer duct occluder in seven ventricular septal defect patients here at Hamad General Hospital, Doha, Qatar. There were 4 male and 3 female patients with an age range of 4 32 years with a median of 8 years and weight range of 16 63 kg with a median of 33 kg. In this group, 6 were perimembranous and 1 muscular and all these ventricular septal defects had a tunnel shape aneurysm. Transesophageal echocardiographic diameter ranged from 4 8 mm and Qp/Qs was 1 1.6. Angiographically, the diameter on the left ventricular side measured 3.5 10 mm and on right ventricular side 2.4 5 mm. 8/6 mm Amplatzer duct occluder was used to close these ventricular septal defects. Results: There were no major complications and immediately after the procedure there was no residual shunt in any of these patients and all the patients remained in normal sinus rhythm. One patient was expatriate and no further follow up was available. The rest of the 6 patients had 1 80 months with a median of 54 months follow up and none of these patients had any residual shunt and all remained in normal sinus rhythm. Two patients developed trivial aortic valve regurgitation immediate post procedure, one remained unchanged and the 2 has progressed to mild at this latest follow up. Conclusion: Amplatzer duct occluder is feasible and a safe device for percutaneous closure of selective tunnel shape aneurysmal perimembranous and muscular ventricular septal defects.