Cardiac rhythm abnormalities after transcatheter device closure of perimembraneous ventricular septal defects in pediatric patients at intermediate term follow up
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2016, Vol 3, Issue 10
Abstract
Background: Transcatheter closure of perimembranous ventricular septal defects in pediatric patients poses special challenges owing to anatomical relationship between conduction system and perimembraneous ventricular septal defect. Aims: The study aims to assess and evaluate the conduction disturbances after transcatheter device closure of perimembranous ventricular septal defect using different occluders at mid-term follow-up. Methods: We studied 297 patients having PMVSD with clinical and/or echocardiographic evidence of a significant left-to-right shunt. All subjects underwent clinical examination, electrocardiogram (ECG), chest X-rays and transthoracic echocardiography before discharge and at 1, 6 and 12-months after the procedure and yearly thereafter. Platelet anti-aggregation therapy with aspirin 5 mg/kg/day orally and endocarditis prophylaxis was prescribed for six months. Results: The mean age of the patients was 8.64±3.14 years (range 3-17.2 years). Majority (86.2%) had no residual shunt at follow-up. Total rhythm disturbances were seen in about 6% (18/297) of patients with transient complete atrioventricular block (CAVB) occurring in 3 patients. There was no mortality in our study which compares well with the surgical results in which it is between 0-3 percent. Conclusions: This study showed that transcatheter closure of PMVSD using symmetric PMVSD occluders and duct occluders is a safe and effective alternative to surgery. Oversizing of devices should be minimized and low profile devices appropriate to specific morphology of VSD should be used. It has excellent results in experienced hands with minimum morbidity and almost no mortality.
Authors and Affiliations
Jayal H Shah, Bhavesh M Thakkar
Keywords
Related Articles
- EP ID EP227314
- DOI 10.17511
- Views 138
- Downloads 0
A study on clinical and echo cardiographic evaluation of neonatal cardiac murmurs and their follow up at 6 weeks of age
Background: The echocardiogram permits early accurate anatomical diagnosis either to reassure parents that the heart was normal, or to detect a heart disease and explain the nature of the abnormality and make an early re...
Clinical profile and outcome of septic shock in children admitted to a tertiary care referral hospital
Background: There is dearth of studies on detailed clinical profile and outcome of pediatric septic shock in India. Objective: To describe clinical profile and outcome of septic shock in children. Methods: This retrospec...
Lipid profile in children with Nephrotic syndrome
Background: To study the derangement of serum lipid profile in children 2 to 12 years with nephrotic syndrome. Methods: 50 children 2 to 12 years with nephrotic syndrome were identified. Patients were classified as remis...
School absenteeism effects on scholastic performance- reality check in India
Introduction: School absenteeism is an important issue, which affects educational achievement and also results in false estimation of the prevalence of disease in school programs. This study was carried out to estimate t...
Abdominal tuberculosis presenting as mass per abdomen: a case report
Tuberculosis (TB) can involve any part of the gastrointestinal tract, the peritoneum, lymphnodes and the pancreatobiliary system. The primary site of TB is usually lung, from where it disseminates to other parts of the b...