Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study
Transcatheter perimembranous ventricular septal defect (pmVSD) closure remains challenging and is seldom used in France given the risk of atrioventricular block (AVB). pmVSD closure with the Nit-Occlud Lê VSD coil was recently introduced in France as an alternative to occluder devices. To study the...
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| Veröffentlicht in: | Archives of cardiovascular diseases 2020-02, Vol.113 (2), p.104-112 |
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| creator | Houeijeh, Ali Godart, François Jalal, Zakaria Ovaert, Caroline Heitz, François Mauran, Pierre Baruteau, Alban-Elouen Guirguis, Lisa Hadeed, Khaled Baudelet, Jean-Benoit Iriart, Xavier Aldebert, Philippe Acar, Philippe Fraisse, Alain Odemis, Ender Karsenty, Clément Thambo, Jean Benoit Hascoët, Sébastien |
| description | Transcatheter perimembranous ventricular septal defect (pmVSD) closure remains challenging and is seldom used in France given the risk of atrioventricular block (AVB). pmVSD closure with the Nit-Occlud Lê VSD coil was recently introduced in France as an alternative to occluder devices.
To study the safety and feasibility of pmVSD closure with the Nit-Occlud Lê VSD coil.
All consecutives cases of pmVSD closure with the Nit-Occlud Lê VSD coil in 20 tertiary French centres were included between January 2015 and December 2018.
Among 46 procedures in five centres, indications for pmVSD closure were left ventricle overload (76.1%), exertional dyspnoea (17.4%), history of infective endocarditis (4.3%) and mild pulmonary hypertension (2.2%). The median (interquartile [IQR]) age of the patients was 13.9 (5.7–31.8) years. Aneurismal tissue was identified in 91.3% of patients. VSD median (IQR) size was 8 (7–10) mm on the left ventricle side and 5 (4–6) mm on the right ventricle side. Implantation was successful in 40 patients (87.0%; 95% confidence interval [CI] 73.7–95.1%). Severe complications occurred in six patients (13.0%, 95% CI 4.9–26.3%), mainly severe haemolysis (8.7%, 95% CI 2.4–20.8%). One aortic valve lesion required surgical aortic valvuloplasty. Occurrence of severe complications was significantly related to the presence of haemolysis (P=0.001), residual shunt (P=0.007) and multi-exit VSD (P=0.005). Residual shunt was observed in 40% of cases with the implanted device shortly after closure and 15% after a median follow-up of 27 months. No immediate or delayed device embolization or complete AVB was recorded.
pmVSD closure with the Nit-Occlud Lê VSD Coil is feasible in older children and adults. However, residual shunting (leading to haemolysis) is a dreaded complication that should not be tolerated. pmVSD closure with the Nit-Occlud Lê VSD as a therapeutic strategy remains controversial and is limited to selected patients.
La fermeture percutanée des communications interventriculaires peri-membraneuses (CIVpm) demeure un challenge et est peu utilisée en France en raison d’un risque de bloc atrio-ventriculaire (BAV). L’utilisation du coil Nit-Occlud Lê VSD a été récemment débutée en France et représente une alternative aux occluders.
Buts Étudier la faisabilité et la sécurité d’emploi de la fermeture percutanée de la CIVpm avec le Nit-Occlud Lê VSD.
Toutes les procédures de fermeture de CIVpm réalisées en France entre janvier 2015 et décembre 2018 dans l |
| doi_str_mv | 10.1016/j.acvd.2019.11.004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03048677v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1875213620300152</els_id><sourcerecordid>2346287633</sourcerecordid><originalsourceid>FETCH-LOGICAL-c434t-674187a1f30ff5d669ae95ff13f7ed4842a6f710125f988b850e05626cd53ba63</originalsourceid><addsrcrecordid>eNp9kc1uEzEURi0EoqXwAiyQl7CYqX9m7BnEJgqUVoraBYWt5djXiiNPJtieoEo8Ea_Bi-FRSpZd-co695PudxB6S0lNCRWX21qbg60ZoX1NaU1I8wyd0062FaOse36auThDr1LaEiKYlOIlOuO07xhv-Tn6fR_1LhmdN5AhYhPGNEXAo8Ma7yH6AYZ1IcYp4QPscvRmCjriBPusA7bgwGT8y-cNvvW5ujMmTBav_v7BP759xsvRh494ga8i7MwGD1PI3swpgFOe7MNr9MLpkODN43uBvl99uV9eV6u7rzfLxaoyDW9yJWRTLtHUceJca4XoNfStc5Q7CbbpGqaFk6US1rq-69ZdS4C0ggljW77Wgl-gD8fcjQ5qX47S8UGN2qvrxUrNf4STphNSHmhh3x_ZfRx_TpCyGnwyEILeQWlBMd4I1knBeUHZETVxTCmCO2VTomZDaqtmQ2o2pChVxVBZeveYP60HsKeV_0oK8OkIQGnk4CGqZHzpD6yPpWxlR_9U_j9Bo6JU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2346287633</pqid></control><display><type>article</type><title>Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>ScienceDirect Journals (5 years ago - present)</source><source>Alma/SFX Local Collection</source><creator>Houeijeh, Ali ; Godart, François ; Jalal, Zakaria ; Ovaert, Caroline ; Heitz, François ; Mauran, Pierre ; Baruteau, Alban-Elouen ; Guirguis, Lisa ; Hadeed, Khaled ; Baudelet, Jean-Benoit ; Iriart, Xavier ; Aldebert, Philippe ; Acar, Philippe ; Fraisse, Alain ; Odemis, Ender ; Karsenty, Clément ; Thambo, Jean Benoit ; Hascoët, Sébastien</creator><creatorcontrib>Houeijeh, Ali ; Godart, François ; Jalal, Zakaria ; Ovaert, Caroline ; Heitz, François ; Mauran, Pierre ; Baruteau, Alban-Elouen ; Guirguis, Lisa ; Hadeed, Khaled ; Baudelet, Jean-Benoit ; Iriart, Xavier ; Aldebert, Philippe ; Acar, Philippe ; Fraisse, Alain ; Odemis, Ender ; Karsenty, Clément ; Thambo, Jean Benoit ; Hascoët, Sébastien</creatorcontrib><description>Transcatheter perimembranous ventricular septal defect (pmVSD) closure remains challenging and is seldom used in France given the risk of atrioventricular block (AVB). pmVSD closure with the Nit-Occlud Lê VSD coil was recently introduced in France as an alternative to occluder devices.
To study the safety and feasibility of pmVSD closure with the Nit-Occlud Lê VSD coil.
All consecutives cases of pmVSD closure with the Nit-Occlud Lê VSD coil in 20 tertiary French centres were included between January 2015 and December 2018.
Among 46 procedures in five centres, indications for pmVSD closure were left ventricle overload (76.1%), exertional dyspnoea (17.4%), history of infective endocarditis (4.3%) and mild pulmonary hypertension (2.2%). The median (interquartile [IQR]) age of the patients was 13.9 (5.7–31.8) years. Aneurismal tissue was identified in 91.3% of patients. VSD median (IQR) size was 8 (7–10) mm on the left ventricle side and 5 (4–6) mm on the right ventricle side. Implantation was successful in 40 patients (87.0%; 95% confidence interval [CI] 73.7–95.1%). Severe complications occurred in six patients (13.0%, 95% CI 4.9–26.3%), mainly severe haemolysis (8.7%, 95% CI 2.4–20.8%). One aortic valve lesion required surgical aortic valvuloplasty. Occurrence of severe complications was significantly related to the presence of haemolysis (P=0.001), residual shunt (P=0.007) and multi-exit VSD (P=0.005). Residual shunt was observed in 40% of cases with the implanted device shortly after closure and 15% after a median follow-up of 27 months. No immediate or delayed device embolization or complete AVB was recorded.
pmVSD closure with the Nit-Occlud Lê VSD Coil is feasible in older children and adults. However, residual shunting (leading to haemolysis) is a dreaded complication that should not be tolerated. pmVSD closure with the Nit-Occlud Lê VSD as a therapeutic strategy remains controversial and is limited to selected patients.
La fermeture percutanée des communications interventriculaires peri-membraneuses (CIVpm) demeure un challenge et est peu utilisée en France en raison d’un risque de bloc atrio-ventriculaire (BAV). L’utilisation du coil Nit-Occlud Lê VSD a été récemment débutée en France et représente une alternative aux occluders.
Buts Étudier la faisabilité et la sécurité d’emploi de la fermeture percutanée de la CIVpm avec le Nit-Occlud Lê VSD.
Toutes les procédures de fermeture de CIVpm réalisées en France entre janvier 2015 et décembre 2018 dans les vingt centres spécialisés de prise en charge des cardiopathies congénitales complexes (réseau maladies rare M3C) ont été incluses rétrospectivement et analysées.
Au total, 46 procédures ont été réalisées dans cinq centres. Les indications de fermeture étaient la surcharge diastolique du ventricule gauche (76 %), une dyspnée à l’effort (17,4), un antécédent d’endocardite (4,3) et une hypertension artérielle pulmonaire modérée (2,2 %). L’âge médian (interquartile) était de 13,9 (5,7–31,8) ans. Un anévrysme du septum interventriculaire a été observé dans 91,3 % des cas. La taille médiane (interquartile) des CIV était de 8 (7–10)mm sur le versant ventriculaire gauche et 5 (4–6)mm sur le versant ventriculaire droit. Le taux de réussite d’implantation de la prothèse était de 87,0 % (IC 95 %, 73,7–95.1 %). Des complications sévères ont été observées chez six patients (13,0 %, IC 95 %, 4,9–26,3 %). L’hémolyse persistante était la complication sévère la plus fréquente (8,7 %, IC 95 % 2,4–20,8 %). Une lésion de la valve aortique a nécessité une valvuloplastie aortique chirurgicale. La survenue de complications est liée à la présence de l’hémolyse (p=0,001) d’un shunt résiduel (p=0,007) et la présence de CIV avec anévrysme multi-perforée (p=0,005). Un shunt résiduel a été documenté dans 40 % des cas juste après l’intervention et 15 % durant le suivi (durée médiane de suivi de 27 mois). Aucun cas de migration de prothèse ni de bloc atrioventriculaire de haut grade n’a été rapporté.
La fermeture percutanée de CIVpm avec le coil Nit-Occlud Lê VSD est réalisable chez les grands enfants et les adultes. La présence d’un shunt résiduel important provoquant une hémolyse parfois sévère est une complication redoutable et ne doit pas être tolérée. La place de cette prothèse dans l’algorithme de prise en charge des CIVpm reste controversée.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2019.11.004</identifier><identifier>PMID: 31982353</identifier><language>eng</language><publisher>Netherlands: Elsevier Masson SAS</publisher><subject>Adolescent ; Adult ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - instrumentation ; Catheterization ; Cathétérisme ; Child ; Child, Preschool ; Communication interventriculaire ; Dilatation ventriculaire gauche ; Feasibility Studies ; Female ; Fermeture de shunt ; France ; Heart Septal Defects, Ventricular - diagnostic imaging ; Heart Septal Defects, Ventricular - physiopathology ; Heart Septal Defects, Ventricular - therapy ; Hemodynamics ; Hemolysis ; Humans ; Left ventricle overload ; Life Sciences ; Male ; Nit-Occlud Lê VSD ; Patient Safety ; Prosthesis Design ; Recovery of Function ; Risk Assessment ; Risk Factors ; Septal Occluder Device ; Shunt closure ; Time Factors ; Treatment Outcome ; Ventricular septal defect ; Young Adult</subject><ispartof>Archives of cardiovascular diseases, 2020-02, Vol.113 (2), p.104-112</ispartof><rights>2020 Elsevier Masson SAS</rights><rights>Copyright © 2020 Elsevier Masson SAS. All rights reserved.</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-674187a1f30ff5d669ae95ff13f7ed4842a6f710125f988b850e05626cd53ba63</citedby><cites>FETCH-LOGICAL-c434t-674187a1f30ff5d669ae95ff13f7ed4842a6f710125f988b850e05626cd53ba63</cites><orcidid>0000-0002-3303-5854 ; 0000-0002-2277-2760 ; 0000-0002-8695-0503 ; 0000-0002-8116-0887 ; 0000-0003-2548-7858 ; 0000-0002-0998-8962</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.acvd.2019.11.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31982353$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03048677$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Houeijeh, Ali</creatorcontrib><creatorcontrib>Godart, François</creatorcontrib><creatorcontrib>Jalal, Zakaria</creatorcontrib><creatorcontrib>Ovaert, Caroline</creatorcontrib><creatorcontrib>Heitz, François</creatorcontrib><creatorcontrib>Mauran, Pierre</creatorcontrib><creatorcontrib>Baruteau, Alban-Elouen</creatorcontrib><creatorcontrib>Guirguis, Lisa</creatorcontrib><creatorcontrib>Hadeed, Khaled</creatorcontrib><creatorcontrib>Baudelet, Jean-Benoit</creatorcontrib><creatorcontrib>Iriart, Xavier</creatorcontrib><creatorcontrib>Aldebert, Philippe</creatorcontrib><creatorcontrib>Acar, Philippe</creatorcontrib><creatorcontrib>Fraisse, Alain</creatorcontrib><creatorcontrib>Odemis, Ender</creatorcontrib><creatorcontrib>Karsenty, Clément</creatorcontrib><creatorcontrib>Thambo, Jean Benoit</creatorcontrib><creatorcontrib>Hascoët, Sébastien</creatorcontrib><title>Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>Transcatheter perimembranous ventricular septal defect (pmVSD) closure remains challenging and is seldom used in France given the risk of atrioventricular block (AVB). pmVSD closure with the Nit-Occlud Lê VSD coil was recently introduced in France as an alternative to occluder devices.
To study the safety and feasibility of pmVSD closure with the Nit-Occlud Lê VSD coil.
All consecutives cases of pmVSD closure with the Nit-Occlud Lê VSD coil in 20 tertiary French centres were included between January 2015 and December 2018.
Among 46 procedures in five centres, indications for pmVSD closure were left ventricle overload (76.1%), exertional dyspnoea (17.4%), history of infective endocarditis (4.3%) and mild pulmonary hypertension (2.2%). The median (interquartile [IQR]) age of the patients was 13.9 (5.7–31.8) years. Aneurismal tissue was identified in 91.3% of patients. VSD median (IQR) size was 8 (7–10) mm on the left ventricle side and 5 (4–6) mm on the right ventricle side. Implantation was successful in 40 patients (87.0%; 95% confidence interval [CI] 73.7–95.1%). Severe complications occurred in six patients (13.0%, 95% CI 4.9–26.3%), mainly severe haemolysis (8.7%, 95% CI 2.4–20.8%). One aortic valve lesion required surgical aortic valvuloplasty. Occurrence of severe complications was significantly related to the presence of haemolysis (P=0.001), residual shunt (P=0.007) and multi-exit VSD (P=0.005). Residual shunt was observed in 40% of cases with the implanted device shortly after closure and 15% after a median follow-up of 27 months. No immediate or delayed device embolization or complete AVB was recorded.
pmVSD closure with the Nit-Occlud Lê VSD Coil is feasible in older children and adults. However, residual shunting (leading to haemolysis) is a dreaded complication that should not be tolerated. pmVSD closure with the Nit-Occlud Lê VSD as a therapeutic strategy remains controversial and is limited to selected patients.
La fermeture percutanée des communications interventriculaires peri-membraneuses (CIVpm) demeure un challenge et est peu utilisée en France en raison d’un risque de bloc atrio-ventriculaire (BAV). L’utilisation du coil Nit-Occlud Lê VSD a été récemment débutée en France et représente une alternative aux occluders.
Buts Étudier la faisabilité et la sécurité d’emploi de la fermeture percutanée de la CIVpm avec le Nit-Occlud Lê VSD.
Toutes les procédures de fermeture de CIVpm réalisées en France entre janvier 2015 et décembre 2018 dans les vingt centres spécialisés de prise en charge des cardiopathies congénitales complexes (réseau maladies rare M3C) ont été incluses rétrospectivement et analysées.
Au total, 46 procédures ont été réalisées dans cinq centres. Les indications de fermeture étaient la surcharge diastolique du ventricule gauche (76 %), une dyspnée à l’effort (17,4), un antécédent d’endocardite (4,3) et une hypertension artérielle pulmonaire modérée (2,2 %). L’âge médian (interquartile) était de 13,9 (5,7–31,8) ans. Un anévrysme du septum interventriculaire a été observé dans 91,3 % des cas. La taille médiane (interquartile) des CIV était de 8 (7–10)mm sur le versant ventriculaire gauche et 5 (4–6)mm sur le versant ventriculaire droit. Le taux de réussite d’implantation de la prothèse était de 87,0 % (IC 95 %, 73,7–95.1 %). Des complications sévères ont été observées chez six patients (13,0 %, IC 95 %, 4,9–26,3 %). L’hémolyse persistante était la complication sévère la plus fréquente (8,7 %, IC 95 % 2,4–20,8 %). Une lésion de la valve aortique a nécessité une valvuloplastie aortique chirurgicale. La survenue de complications est liée à la présence de l’hémolyse (p=0,001) d’un shunt résiduel (p=0,007) et la présence de CIV avec anévrysme multi-perforée (p=0,005). Un shunt résiduel a été documenté dans 40 % des cas juste après l’intervention et 15 % durant le suivi (durée médiane de suivi de 27 mois). Aucun cas de migration de prothèse ni de bloc atrioventriculaire de haut grade n’a été rapporté.
La fermeture percutanée de CIVpm avec le coil Nit-Occlud Lê VSD est réalisable chez les grands enfants et les adultes. La présence d’un shunt résiduel important provoquant une hémolyse parfois sévère est une complication redoutable et ne doit pas être tolérée. La place de cette prothèse dans l’algorithme de prise en charge des CIVpm reste controversée.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Cardiac Catheterization - instrumentation</subject><subject>Catheterization</subject><subject>Cathétérisme</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Communication interventriculaire</subject><subject>Dilatation ventriculaire gauche</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Fermeture de shunt</subject><subject>France</subject><subject>Heart Septal Defects, Ventricular - diagnostic imaging</subject><subject>Heart Septal Defects, Ventricular - physiopathology</subject><subject>Heart Septal Defects, Ventricular - therapy</subject><subject>Hemodynamics</subject><subject>Hemolysis</subject><subject>Humans</subject><subject>Left ventricle overload</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Nit-Occlud Lê VSD</subject><subject>Patient Safety</subject><subject>Prosthesis Design</subject><subject>Recovery of Function</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Septal Occluder Device</subject><subject>Shunt closure</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular septal defect</subject><subject>Young Adult</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1uEzEURi0EoqXwAiyQl7CYqX9m7BnEJgqUVoraBYWt5djXiiNPJtieoEo8Ea_Bi-FRSpZd-co695PudxB6S0lNCRWX21qbg60ZoX1NaU1I8wyd0062FaOse36auThDr1LaEiKYlOIlOuO07xhv-Tn6fR_1LhmdN5AhYhPGNEXAo8Ma7yH6AYZ1IcYp4QPscvRmCjriBPusA7bgwGT8y-cNvvW5ujMmTBav_v7BP759xsvRh494ga8i7MwGD1PI3swpgFOe7MNr9MLpkODN43uBvl99uV9eV6u7rzfLxaoyDW9yJWRTLtHUceJca4XoNfStc5Q7CbbpGqaFk6US1rq-69ZdS4C0ggljW77Wgl-gD8fcjQ5qX47S8UGN2qvrxUrNf4STphNSHmhh3x_ZfRx_TpCyGnwyEILeQWlBMd4I1knBeUHZETVxTCmCO2VTomZDaqtmQ2o2pChVxVBZeveYP60HsKeV_0oK8OkIQGnk4CGqZHzpD6yPpWxlR_9U_j9Bo6JU</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Houeijeh, Ali</creator><creator>Godart, François</creator><creator>Jalal, Zakaria</creator><creator>Ovaert, Caroline</creator><creator>Heitz, François</creator><creator>Mauran, Pierre</creator><creator>Baruteau, Alban-Elouen</creator><creator>Guirguis, Lisa</creator><creator>Hadeed, Khaled</creator><creator>Baudelet, Jean-Benoit</creator><creator>Iriart, Xavier</creator><creator>Aldebert, Philippe</creator><creator>Acar, Philippe</creator><creator>Fraisse, Alain</creator><creator>Odemis, Ender</creator><creator>Karsenty, Clément</creator><creator>Thambo, Jean Benoit</creator><creator>Hascoët, Sébastien</creator><general>Elsevier Masson SAS</general><general>Elsevier ; Société française de cardiologie [2008-....]</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-3303-5854</orcidid><orcidid>https://orcid.org/0000-0002-2277-2760</orcidid><orcidid>https://orcid.org/0000-0002-8695-0503</orcidid><orcidid>https://orcid.org/0000-0002-8116-0887</orcidid><orcidid>https://orcid.org/0000-0003-2548-7858</orcidid><orcidid>https://orcid.org/0000-0002-0998-8962</orcidid></search><sort><creationdate>202002</creationdate><title>Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study</title><author>Houeijeh, Ali ; Godart, François ; Jalal, Zakaria ; Ovaert, Caroline ; Heitz, François ; Mauran, Pierre ; Baruteau, Alban-Elouen ; Guirguis, Lisa ; Hadeed, Khaled ; Baudelet, Jean-Benoit ; Iriart, Xavier ; Aldebert, Philippe ; Acar, Philippe ; Fraisse, Alain ; Odemis, Ender ; Karsenty, Clément ; Thambo, Jean Benoit ; Hascoët, Sébastien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-674187a1f30ff5d669ae95ff13f7ed4842a6f710125f988b850e05626cd53ba63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Cardiac Catheterization - instrumentation</topic><topic>Catheterization</topic><topic>Cathétérisme</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Communication interventriculaire</topic><topic>Dilatation ventriculaire gauche</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Fermeture de shunt</topic><topic>France</topic><topic>Heart Septal Defects, Ventricular - diagnostic imaging</topic><topic>Heart Septal Defects, Ventricular - physiopathology</topic><topic>Heart Septal Defects, Ventricular - therapy</topic><topic>Hemodynamics</topic><topic>Hemolysis</topic><topic>Humans</topic><topic>Left ventricle overload</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Nit-Occlud Lê VSD</topic><topic>Patient Safety</topic><topic>Prosthesis Design</topic><topic>Recovery of Function</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Septal Occluder Device</topic><topic>Shunt closure</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular septal defect</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Houeijeh, Ali</creatorcontrib><creatorcontrib>Godart, François</creatorcontrib><creatorcontrib>Jalal, Zakaria</creatorcontrib><creatorcontrib>Ovaert, Caroline</creatorcontrib><creatorcontrib>Heitz, François</creatorcontrib><creatorcontrib>Mauran, Pierre</creatorcontrib><creatorcontrib>Baruteau, Alban-Elouen</creatorcontrib><creatorcontrib>Guirguis, Lisa</creatorcontrib><creatorcontrib>Hadeed, Khaled</creatorcontrib><creatorcontrib>Baudelet, Jean-Benoit</creatorcontrib><creatorcontrib>Iriart, Xavier</creatorcontrib><creatorcontrib>Aldebert, Philippe</creatorcontrib><creatorcontrib>Acar, Philippe</creatorcontrib><creatorcontrib>Fraisse, Alain</creatorcontrib><creatorcontrib>Odemis, Ender</creatorcontrib><creatorcontrib>Karsenty, Clément</creatorcontrib><creatorcontrib>Thambo, Jean Benoit</creatorcontrib><creatorcontrib>Hascoët, Sébastien</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Houeijeh, Ali</au><au>Godart, François</au><au>Jalal, Zakaria</au><au>Ovaert, Caroline</au><au>Heitz, François</au><au>Mauran, Pierre</au><au>Baruteau, Alban-Elouen</au><au>Guirguis, Lisa</au><au>Hadeed, Khaled</au><au>Baudelet, Jean-Benoit</au><au>Iriart, Xavier</au><au>Aldebert, Philippe</au><au>Acar, Philippe</au><au>Fraisse, Alain</au><au>Odemis, Ender</au><au>Karsenty, Clément</au><au>Thambo, Jean Benoit</au><au>Hascoët, Sébastien</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2020-02</date><risdate>2020</risdate><volume>113</volume><issue>2</issue><spage>104</spage><epage>112</epage><pages>104-112</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>Transcatheter perimembranous ventricular septal defect (pmVSD) closure remains challenging and is seldom used in France given the risk of atrioventricular block (AVB). pmVSD closure with the Nit-Occlud Lê VSD coil was recently introduced in France as an alternative to occluder devices.
To study the safety and feasibility of pmVSD closure with the Nit-Occlud Lê VSD coil.
All consecutives cases of pmVSD closure with the Nit-Occlud Lê VSD coil in 20 tertiary French centres were included between January 2015 and December 2018.
Among 46 procedures in five centres, indications for pmVSD closure were left ventricle overload (76.1%), exertional dyspnoea (17.4%), history of infective endocarditis (4.3%) and mild pulmonary hypertension (2.2%). The median (interquartile [IQR]) age of the patients was 13.9 (5.7–31.8) years. Aneurismal tissue was identified in 91.3% of patients. VSD median (IQR) size was 8 (7–10) mm on the left ventricle side and 5 (4–6) mm on the right ventricle side. Implantation was successful in 40 patients (87.0%; 95% confidence interval [CI] 73.7–95.1%). Severe complications occurred in six patients (13.0%, 95% CI 4.9–26.3%), mainly severe haemolysis (8.7%, 95% CI 2.4–20.8%). One aortic valve lesion required surgical aortic valvuloplasty. Occurrence of severe complications was significantly related to the presence of haemolysis (P=0.001), residual shunt (P=0.007) and multi-exit VSD (P=0.005). Residual shunt was observed in 40% of cases with the implanted device shortly after closure and 15% after a median follow-up of 27 months. No immediate or delayed device embolization or complete AVB was recorded.
pmVSD closure with the Nit-Occlud Lê VSD Coil is feasible in older children and adults. However, residual shunting (leading to haemolysis) is a dreaded complication that should not be tolerated. pmVSD closure with the Nit-Occlud Lê VSD as a therapeutic strategy remains controversial and is limited to selected patients.
La fermeture percutanée des communications interventriculaires peri-membraneuses (CIVpm) demeure un challenge et est peu utilisée en France en raison d’un risque de bloc atrio-ventriculaire (BAV). L’utilisation du coil Nit-Occlud Lê VSD a été récemment débutée en France et représente une alternative aux occluders.
Buts Étudier la faisabilité et la sécurité d’emploi de la fermeture percutanée de la CIVpm avec le Nit-Occlud Lê VSD.
Toutes les procédures de fermeture de CIVpm réalisées en France entre janvier 2015 et décembre 2018 dans les vingt centres spécialisés de prise en charge des cardiopathies congénitales complexes (réseau maladies rare M3C) ont été incluses rétrospectivement et analysées.
Au total, 46 procédures ont été réalisées dans cinq centres. Les indications de fermeture étaient la surcharge diastolique du ventricule gauche (76 %), une dyspnée à l’effort (17,4), un antécédent d’endocardite (4,3) et une hypertension artérielle pulmonaire modérée (2,2 %). L’âge médian (interquartile) était de 13,9 (5,7–31,8) ans. Un anévrysme du septum interventriculaire a été observé dans 91,3 % des cas. La taille médiane (interquartile) des CIV était de 8 (7–10)mm sur le versant ventriculaire gauche et 5 (4–6)mm sur le versant ventriculaire droit. Le taux de réussite d’implantation de la prothèse était de 87,0 % (IC 95 %, 73,7–95.1 %). Des complications sévères ont été observées chez six patients (13,0 %, IC 95 %, 4,9–26,3 %). L’hémolyse persistante était la complication sévère la plus fréquente (8,7 %, IC 95 % 2,4–20,8 %). Une lésion de la valve aortique a nécessité une valvuloplastie aortique chirurgicale. La survenue de complications est liée à la présence de l’hémolyse (p=0,001) d’un shunt résiduel (p=0,007) et la présence de CIV avec anévrysme multi-perforée (p=0,005). Un shunt résiduel a été documenté dans 40 % des cas juste après l’intervention et 15 % durant le suivi (durée médiane de suivi de 27 mois). Aucun cas de migration de prothèse ni de bloc atrioventriculaire de haut grade n’a été rapporté.
La fermeture percutanée de CIVpm avec le coil Nit-Occlud Lê VSD est réalisable chez les grands enfants et les adultes. La présence d’un shunt résiduel important provoquant une hémolyse parfois sévère est une complication redoutable et ne doit pas être tolérée. La place de cette prothèse dans l’algorithme de prise en charge des CIVpm reste controversée.</abstract><cop>Netherlands</cop><pub>Elsevier Masson SAS</pub><pmid>31982353</pmid><doi>10.1016/j.acvd.2019.11.004</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3303-5854</orcidid><orcidid>https://orcid.org/0000-0002-2277-2760</orcidid><orcidid>https://orcid.org/0000-0002-8695-0503</orcidid><orcidid>https://orcid.org/0000-0002-8116-0887</orcidid><orcidid>https://orcid.org/0000-0003-2548-7858</orcidid><orcidid>https://orcid.org/0000-0002-0998-8962</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1875-2136 |
| ispartof | Archives of cardiovascular diseases, 2020-02, Vol.113 (2), p.104-112 |
| issn | 1875-2136 1875-2128 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03048677v1 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present); Alma/SFX Local Collection |
| subjects | Adolescent Adult Cardiac Catheterization - adverse effects Cardiac Catheterization - instrumentation Catheterization Cathétérisme Child Child, Preschool Communication interventriculaire Dilatation ventriculaire gauche Feasibility Studies Female Fermeture de shunt France Heart Septal Defects, Ventricular - diagnostic imaging Heart Septal Defects, Ventricular - physiopathology Heart Septal Defects, Ventricular - therapy Hemodynamics Hemolysis Humans Left ventricle overload Life Sciences Male Nit-Occlud Lê VSD Patient Safety Prosthesis Design Recovery of Function Risk Assessment Risk Factors Septal Occluder Device Shunt closure Time Factors Treatment Outcome Ventricular septal defect Young Adult |
| title | Transcatheter closure of a perimembranous ventricular septal defect with Nit-Occlud Lê VSD Coil: A French multicentre study |
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