DOUBLY COMMITTED SUB ARTERIAL VENTRICULAR SEPTAL DEEFCT DEVICE CLOSURE USING NIT-OCCLUD® PDA-R DEVICE: INITIAL EXPERIENCE IN PAKISTA

Abstract

Objective: To assess the suitability of transcatheter closure of doubly committed subarterial ventricular septal defect (DCSAVSD) with PDA-R device for the first time in Pakistan.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Paeds Cardiology department AFIC/NIHD Rawalpindi, from Dec 2018 to Jul 2019.

Methodology: A total of ten patients with DCSAVSD more than three years of age with no other associated congenital cardiac malformations were subjected to device closure. Few patients had mild aortic valve regurgitation. Device used was PDA-R pfm-nitocclud which is preloaded to the delivery system. The procedure was carried out under general anesthesia and monitoring of heart rate and hemodynamics. Preliminary detailed echocardiogram was done to assess the suitability of device closure. All patients were followed post procedure.

Results: Complete closure was attained in all patients with no residual flow. No mortality was faced. Two patients had brief episode of heat block during the arteriovenous loop creation which subsided at the end of procedure.

Conclusion: Patients with DCSAVSD can be closed effectively with PDA-R device. Selection of cases should be adequate matching the VSD with the device size. This procedure is good alternate to surgical closure avoiding scar, cost and hospital stay.