Long-term outcome of perimembranous VSD closure using the Nit-Occlud® Lê VSD coil system

Clin Res Cardiol. 2021 Mar;110(3):382-390. doi: 10.1007/s00392-020-01750-6. Epub 2020 Oct 31.

Abstract

Objective: This study presents data from the admission trial to show the feasibility, safety and effectiveness of the Nit-Occlud® Lê VSD in the treatment of perimembranous ventricular septal defects with an aneurysmal configuration and a diameter up to 8 mm.

Background: The majority of ventricular septal defects (VSD) are still closed surgically, while a less invasive transcatheter treatment by closure devices is available. Device-based closure is reported to be associated with the risk of complete atrio-ventricular block, especially with double-disc devices in perimembranous defects.

Methods: In six tertiary centers in Germany and Israel, an interventional closure of a periembranous VSD was attempted in 88 patients using the Nit-Occlud® Lê VSD.

Results: The interventional VSD closure was performed in 85 patients. Patients had a median age of 8.0 (2-65) years and a median body weight of 26.7 (10-109) kg. A complete closure of the defects was achieved in 85.4% 2 weeks after device implantation, in 88.9% after three months and in 98.6% at the 5-year follow-up. There was no incidence of death during the study nor did any patient suffer of permanent atrio-ventricular block of higher degree. Serious adverse events, by definition, are potentially life-threatening or require surgery to correct, while major serious events require medical or transcatheter intervention to correct. The study results exhibit a serious adverse event rate of 3.5% (3/85 patients) and a major adverse event rate of 5.9% (5/85 patients).

Conclusion: The Nit-Occlud® Lê VSD coil offers the possibility of an effective and safe approach in patients with aneurysmal perimembranous ventricular septal defects.

Keywords: Admission trial; Five-year follow-up; Interventional therapy; VSD coil system; Ventricular septal defect.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiac Catheterization / methods*
  • Cardiac Surgical Procedures / methods*
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Ventricular / surgery*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Retrospective Studies
  • Septal Occluder Device*
  • Time Factors
  • Treatment Outcome
  • Young Adult