New device for closure of muscular ventricular septal defects in a canine model

Zahid Amin, Xiaoping Gu, James M. Berry, John L. Bass, Jack L. Titus, Myra Urness, Young Min Han, Kurt Amplatz

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Background - Repair of muscular ventricular septal defects (MVSDs) has always been challenging to the surgeon. Long-term morbidity and mortality are significantly increased if the defects are closed via left ventriculotomy or if they are associated with other complex congenital anomalies. The purpose of this study was to close MVSDs with the Amplatz ventricular septal defect device. This device is constructed from 0.004-in nitinol wire mesh filled with polyester fibers. It is retrievable, repositionable, self-centering, and of low profile. Methods and Results - MVSDs were created with the help of a sharp punch in 10 dogs. The location of the defects was anterior muscular (n=3), midmuscular (n=3), apical (n=3), and inlet muscular (n=1). The diameter of the defects ranged from 6 to 14 mm. All defects were closed in the catheterization laboratory. The device was placed with the help of transesophageal echocardiography and fluoroscopy. A 7F sheath was used to deploy the device from the right ventricular side in 8 and the left ventricular side in 2 dogs. Placement was successful in all animals. The complete closure rate was 30% (3/10) immediately after placement and 100% at 1-week follow-up. Pathological examination of the heart revealed complete endothelialization of the device in dogs killed after 3 months. Conclusions - The Amplatz ventricular septal defect device appears highly efficacious in closing MVSDs. The advantages include a small delivery sheath, complete retrievability before release, and the fact that it is self-centering and self-expanding, thereby making it an attractive option in smaller children.

Original languageEnglish (US)
Pages (from-to)320-328
Number of pages9
JournalCirculation
Volume100
Issue number3
DOIs
StatePublished - Jul 20 1999

Fingerprint

Ventricular Heart Septal Defects
Canidae
Equipment and Supplies
Dogs
Polyesters
Fluoroscopy
Transesophageal Echocardiography
Catheterization
Morbidity
Mortality

Keywords

  • Catheterization
  • Heart defects, congenital
  • Heart septal defects
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Amin, Z., Gu, X., Berry, J. M., Bass, J. L., Titus, J. L., Urness, M., ... Amplatz, K. (1999). New device for closure of muscular ventricular septal defects in a canine model. Circulation, 100(3), 320-328. https://doi.org/10.1161/01.CIR.100.3.320

New device for closure of muscular ventricular septal defects in a canine model. / Amin, Zahid; Gu, Xiaoping; Berry, James M.; Bass, John L.; Titus, Jack L.; Urness, Myra; Han, Young Min; Amplatz, Kurt.

In: Circulation, Vol. 100, No. 3, 20.07.1999, p. 320-328.

Research output: Contribution to journalArticle

Amin, Z, Gu, X, Berry, JM, Bass, JL, Titus, JL, Urness, M, Han, YM & Amplatz, K 1999, 'New device for closure of muscular ventricular septal defects in a canine model', Circulation, vol. 100, no. 3, pp. 320-328. https://doi.org/10.1161/01.CIR.100.3.320
Amin, Zahid ; Gu, Xiaoping ; Berry, James M. ; Bass, John L. ; Titus, Jack L. ; Urness, Myra ; Han, Young Min ; Amplatz, Kurt. / New device for closure of muscular ventricular septal defects in a canine model. In: Circulation. 1999 ; Vol. 100, No. 3. pp. 320-328.
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AB - Background - Repair of muscular ventricular septal defects (MVSDs) has always been challenging to the surgeon. Long-term morbidity and mortality are significantly increased if the defects are closed via left ventriculotomy or if they are associated with other complex congenital anomalies. The purpose of this study was to close MVSDs with the Amplatz ventricular septal defect device. This device is constructed from 0.004-in nitinol wire mesh filled with polyester fibers. It is retrievable, repositionable, self-centering, and of low profile. Methods and Results - MVSDs were created with the help of a sharp punch in 10 dogs. The location of the defects was anterior muscular (n=3), midmuscular (n=3), apical (n=3), and inlet muscular (n=1). The diameter of the defects ranged from 6 to 14 mm. All defects were closed in the catheterization laboratory. The device was placed with the help of transesophageal echocardiography and fluoroscopy. A 7F sheath was used to deploy the device from the right ventricular side in 8 and the left ventricular side in 2 dogs. Placement was successful in all animals. The complete closure rate was 30% (3/10) immediately after placement and 100% at 1-week follow-up. Pathological examination of the heart revealed complete endothelialization of the device in dogs killed after 3 months. Conclusions - The Amplatz ventricular septal defect device appears highly efficacious in closing MVSDs. The advantages include a small delivery sheath, complete retrievability before release, and the fact that it is self-centering and self-expanding, thereby making it an attractive option in smaller children.

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