Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience
Objectives To determine event‐free survival after transcatheter closure of ventricular septal defect (VSD), and to identify predictors of adverse events (AE) in post myocardial infarction VSD (post‐MI VSD) subgroup. Background There are limited data on mid‐term follow‐up after transcatheter VSD clos...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2015-12, Vol.86 (7), p.1264-1270 |
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| creator | Egbe, Alexander C. Poterucha, Joseph T. Rihal, Charanjit S. Taggart, Nathaniel W. Cetta, Frank Cabalka, Allison K. Pollak, Peter M. Reeder, Guy S. Hagler, Donald J. |
| description | Objectives
To determine event‐free survival after transcatheter closure of ventricular septal defect (VSD), and to identify predictors of adverse events (AE) in post myocardial infarction VSD (post‐MI VSD) subgroup.
Background
There are limited data on mid‐term follow‐up after transcatheter VSD closure.
Methods
Retrospective review of 27 cases of transcatheter VSD closure (post‐MI = 18 and non‐ischemic = 9) performed from 1999 to 2013. We defined AE as death, device embolization, hemolysis requiring blood transfusion, heart block and reintervention.
Results
In the post‐MI VSD subgroup, mean age and follow‐up was 69 ± 11 and 7.3 ± 7 years, respectively. AE occurred in 8 (44%) patients (death‐3, device embolization‐1, hemolysis‐1, surgical VSD closure‐2, reintervention‐1). Event‐free survival was 56% at 1 month and 5 years, and all AE occurred in the periprocedural period. Cardiogenic shock (HR: 3.21, CI: 1.82–5.41, P = 0.002), and VSD closure in acute phase (HR: 2.14, CI: 1.12–4.31, P = 0.004) were independent predictors of AE. In the non‐ischemic VSD subgroup, mean age and follow‐up was 49 ± 15 and 8.7 ± 8 years, respectively. AE occurred in 3 (33%) patients (late death‐1, surgical VSD closure‐2). For the entire cohort, freedom from death was 89% and 85% at 1 month and 5 years, and event‐free survival was 70% and 61% at 1 month and 5 years.
Conclusions
Transcatheter closure of post‐MI VSD carries a moderate risk of periprocedural complications but low event rates afterwards. By comparison, device closure of non‐ischemic VSD has lower periprocedural morbidity but some patients continued to experience AE during follow‐up. © 2015 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/ccd.25989 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1735325985</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1735325985</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4619-2af29887dc87f51db815403890ad7a1c5949494ac24fbc6681db3e3d0fbc69863</originalsourceid><addsrcrecordid>eNp1kctu1DAUhi0EohdY8ALIEhsqNa0viRN3hwJ0kIayGQQ7y-OcUJeMHWyndN6Ax8bpTLtAQl4cH-n7fln-EXpFyRklhJ0b052xSjbyCTqkFWNFzcT3p_s7laU4QEcx3hBCpGDyOTpggnDOanaI_qyCdtHodA0JAjaDj1MA7Hs8-pg2W2906KwesHW9DiZZ706x1Sn4H-CsOcXadfeoHyHoZG8B34JLwZpp0AFHGFOWO-jBpHiBV9eAP-utx-1gs47hLmsWnIEX6Fmvhwgv9_MYff34YdUuiuWXy0_tu2VhSkFlwXTPZNPUnWnqvqLduqFVSXgjie5qTU0ly_low8p-bYRoMsKBd2TeZCP4MXq7yx2D_zVBTGpjo4Fh0A78FBWtecXnz6wy-uYf9MZPweXXzVTJOJWCZupkR5ngYwzQqzHYjQ5bRYma61G5HnVfT2Zf7xOn9Qa6R_Khjwyc74DfdoDt_5NU275_iCx2ho0J7h4NHX4qUfO6Ut-uLtWiFVeCLkq15H8BHMWqWQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1734231961</pqid></control><display><type>article</type><title>Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Egbe, Alexander C. ; Poterucha, Joseph T. ; Rihal, Charanjit S. ; Taggart, Nathaniel W. ; Cetta, Frank ; Cabalka, Allison K. ; Pollak, Peter M. ; Reeder, Guy S. ; Hagler, Donald J.</creator><creatorcontrib>Egbe, Alexander C. ; Poterucha, Joseph T. ; Rihal, Charanjit S. ; Taggart, Nathaniel W. ; Cetta, Frank ; Cabalka, Allison K. ; Pollak, Peter M. ; Reeder, Guy S. ; Hagler, Donald J.</creatorcontrib><description>Objectives
To determine event‐free survival after transcatheter closure of ventricular septal defect (VSD), and to identify predictors of adverse events (AE) in post myocardial infarction VSD (post‐MI VSD) subgroup.
Background
There are limited data on mid‐term follow‐up after transcatheter VSD closure.
Methods
Retrospective review of 27 cases of transcatheter VSD closure (post‐MI = 18 and non‐ischemic = 9) performed from 1999 to 2013. We defined AE as death, device embolization, hemolysis requiring blood transfusion, heart block and reintervention.
Results
In the post‐MI VSD subgroup, mean age and follow‐up was 69 ± 11 and 7.3 ± 7 years, respectively. AE occurred in 8 (44%) patients (death‐3, device embolization‐1, hemolysis‐1, surgical VSD closure‐2, reintervention‐1). Event‐free survival was 56% at 1 month and 5 years, and all AE occurred in the periprocedural period. Cardiogenic shock (HR: 3.21, CI: 1.82–5.41, P = 0.002), and VSD closure in acute phase (HR: 2.14, CI: 1.12–4.31, P = 0.004) were independent predictors of AE. In the non‐ischemic VSD subgroup, mean age and follow‐up was 49 ± 15 and 8.7 ± 8 years, respectively. AE occurred in 3 (33%) patients (late death‐1, surgical VSD closure‐2). For the entire cohort, freedom from death was 89% and 85% at 1 month and 5 years, and event‐free survival was 70% and 61% at 1 month and 5 years.
Conclusions
Transcatheter closure of post‐MI VSD carries a moderate risk of periprocedural complications but low event rates afterwards. By comparison, device closure of non‐ischemic VSD has lower periprocedural morbidity but some patients continued to experience AE during follow‐up. © 2015 Wiley Periodicals, Inc.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.25989</identifier><identifier>PMID: 26033272</identifier><identifier>CODEN: CARIF2</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - instrumentation ; Cardiac Catheterization - mortality ; Disease-Free Survival ; Female ; Heart Septum - diagnostic imaging ; Heart Septum - injuries ; Humans ; Iatrogenic Disease ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Minnesota ; myocardial infarction ; Myocardial Infarction - complications ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Postoperative Complications - therapy ; Proportional Hazards Models ; Radiography ; Retrospective Studies ; Risk Factors ; Septal Occluder Device ; Time Factors ; transcatheter ; Treatment Outcome ; ventricular septal defect ; Ventricular Septal Rupture - diagnosis ; Ventricular Septal Rupture - etiology ; Ventricular Septal Rupture - mortality ; Ventricular Septal Rupture - therapy</subject><ispartof>Catheterization and cardiovascular interventions, 2015-12, Vol.86 (7), p.1264-1270</ispartof><rights>2015 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4619-2af29887dc87f51db815403890ad7a1c5949494ac24fbc6681db3e3d0fbc69863</citedby><cites>FETCH-LOGICAL-c4619-2af29887dc87f51db815403890ad7a1c5949494ac24fbc6681db3e3d0fbc69863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.25989$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.25989$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26033272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egbe, Alexander C.</creatorcontrib><creatorcontrib>Poterucha, Joseph T.</creatorcontrib><creatorcontrib>Rihal, Charanjit S.</creatorcontrib><creatorcontrib>Taggart, Nathaniel W.</creatorcontrib><creatorcontrib>Cetta, Frank</creatorcontrib><creatorcontrib>Cabalka, Allison K.</creatorcontrib><creatorcontrib>Pollak, Peter M.</creatorcontrib><creatorcontrib>Reeder, Guy S.</creatorcontrib><creatorcontrib>Hagler, Donald J.</creatorcontrib><title>Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience</title><title>Catheterization and cardiovascular interventions</title><addtitle>Cathet. Cardiovasc. Intervent</addtitle><description>Objectives
To determine event‐free survival after transcatheter closure of ventricular septal defect (VSD), and to identify predictors of adverse events (AE) in post myocardial infarction VSD (post‐MI VSD) subgroup.
Background
There are limited data on mid‐term follow‐up after transcatheter VSD closure.
Methods
Retrospective review of 27 cases of transcatheter VSD closure (post‐MI = 18 and non‐ischemic = 9) performed from 1999 to 2013. We defined AE as death, device embolization, hemolysis requiring blood transfusion, heart block and reintervention.
Results
In the post‐MI VSD subgroup, mean age and follow‐up was 69 ± 11 and 7.3 ± 7 years, respectively. AE occurred in 8 (44%) patients (death‐3, device embolization‐1, hemolysis‐1, surgical VSD closure‐2, reintervention‐1). Event‐free survival was 56% at 1 month and 5 years, and all AE occurred in the periprocedural period. Cardiogenic shock (HR: 3.21, CI: 1.82–5.41, P = 0.002), and VSD closure in acute phase (HR: 2.14, CI: 1.12–4.31, P = 0.004) were independent predictors of AE. In the non‐ischemic VSD subgroup, mean age and follow‐up was 49 ± 15 and 8.7 ± 8 years, respectively. AE occurred in 3 (33%) patients (late death‐1, surgical VSD closure‐2). For the entire cohort, freedom from death was 89% and 85% at 1 month and 5 years, and event‐free survival was 70% and 61% at 1 month and 5 years.
Conclusions
Transcatheter closure of post‐MI VSD carries a moderate risk of periprocedural complications but low event rates afterwards. By comparison, device closure of non‐ischemic VSD has lower periprocedural morbidity but some patients continued to experience AE during follow‐up. © 2015 Wiley Periodicals, Inc.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Cardiac Catheterization - instrumentation</subject><subject>Cardiac Catheterization - mortality</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Heart Septum - diagnostic imaging</subject><subject>Heart Septum - injuries</subject><subject>Humans</subject><subject>Iatrogenic Disease</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minnesota</subject><subject>myocardial infarction</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - mortality</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - therapy</subject><subject>Proportional Hazards Models</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Septal Occluder Device</subject><subject>Time Factors</subject><subject>transcatheter</subject><subject>Treatment Outcome</subject><subject>ventricular septal defect</subject><subject>Ventricular Septal Rupture - diagnosis</subject><subject>Ventricular Septal Rupture - etiology</subject><subject>Ventricular Septal Rupture - mortality</subject><subject>Ventricular Septal Rupture - therapy</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhi0EohdY8ALIEhsqNa0viRN3hwJ0kIayGQQ7y-OcUJeMHWyndN6Ax8bpTLtAQl4cH-n7fln-EXpFyRklhJ0b052xSjbyCTqkFWNFzcT3p_s7laU4QEcx3hBCpGDyOTpggnDOanaI_qyCdtHodA0JAjaDj1MA7Hs8-pg2W2906KwesHW9DiZZ706x1Sn4H-CsOcXadfeoHyHoZG8B34JLwZpp0AFHGFOWO-jBpHiBV9eAP-utx-1gs47hLmsWnIEX6Fmvhwgv9_MYff34YdUuiuWXy0_tu2VhSkFlwXTPZNPUnWnqvqLduqFVSXgjie5qTU0ly_low8p-bYRoMsKBd2TeZCP4MXq7yx2D_zVBTGpjo4Fh0A78FBWtecXnz6wy-uYf9MZPweXXzVTJOJWCZupkR5ngYwzQqzHYjQ5bRYma61G5HnVfT2Zf7xOn9Qa6R_Khjwyc74DfdoDt_5NU275_iCx2ho0J7h4NHX4qUfO6Ut-uLtWiFVeCLkq15H8BHMWqWQ</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Egbe, Alexander C.</creator><creator>Poterucha, Joseph T.</creator><creator>Rihal, Charanjit S.</creator><creator>Taggart, Nathaniel W.</creator><creator>Cetta, Frank</creator><creator>Cabalka, Allison K.</creator><creator>Pollak, Peter M.</creator><creator>Reeder, Guy S.</creator><creator>Hagler, Donald J.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><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>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20151201</creationdate><title>Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience</title><author>Egbe, Alexander C. ; Poterucha, Joseph T. ; Rihal, Charanjit S. ; Taggart, Nathaniel W. ; Cetta, Frank ; Cabalka, Allison K. ; Pollak, Peter M. ; Reeder, Guy S. ; Hagler, Donald J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4619-2af29887dc87f51db815403890ad7a1c5949494ac24fbc6681db3e3d0fbc69863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Cardiac Catheterization - instrumentation</topic><topic>Cardiac Catheterization - mortality</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Heart Septum - diagnostic imaging</topic><topic>Heart Septum - injuries</topic><topic>Humans</topic><topic>Iatrogenic Disease</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minnesota</topic><topic>myocardial infarction</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - mortality</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - therapy</topic><topic>Proportional Hazards Models</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Septal Occluder Device</topic><topic>Time Factors</topic><topic>transcatheter</topic><topic>Treatment Outcome</topic><topic>ventricular septal defect</topic><topic>Ventricular Septal Rupture - diagnosis</topic><topic>Ventricular Septal Rupture - etiology</topic><topic>Ventricular Septal Rupture - mortality</topic><topic>Ventricular Septal Rupture - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egbe, Alexander C.</creatorcontrib><creatorcontrib>Poterucha, Joseph T.</creatorcontrib><creatorcontrib>Rihal, Charanjit S.</creatorcontrib><creatorcontrib>Taggart, Nathaniel W.</creatorcontrib><creatorcontrib>Cetta, Frank</creatorcontrib><creatorcontrib>Cabalka, Allison K.</creatorcontrib><creatorcontrib>Pollak, Peter M.</creatorcontrib><creatorcontrib>Reeder, Guy S.</creatorcontrib><creatorcontrib>Hagler, Donald J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egbe, Alexander C.</au><au>Poterucha, Joseph T.</au><au>Rihal, Charanjit S.</au><au>Taggart, Nathaniel W.</au><au>Cetta, Frank</au><au>Cabalka, Allison K.</au><au>Pollak, Peter M.</au><au>Reeder, Guy S.</au><au>Hagler, Donald J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Cathet. Cardiovasc. Intervent</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>86</volume><issue>7</issue><spage>1264</spage><epage>1270</epage><pages>1264-1270</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><coden>CARIF2</coden><abstract>Objectives
To determine event‐free survival after transcatheter closure of ventricular septal defect (VSD), and to identify predictors of adverse events (AE) in post myocardial infarction VSD (post‐MI VSD) subgroup.
Background
There are limited data on mid‐term follow‐up after transcatheter VSD closure.
Methods
Retrospective review of 27 cases of transcatheter VSD closure (post‐MI = 18 and non‐ischemic = 9) performed from 1999 to 2013. We defined AE as death, device embolization, hemolysis requiring blood transfusion, heart block and reintervention.
Results
In the post‐MI VSD subgroup, mean age and follow‐up was 69 ± 11 and 7.3 ± 7 years, respectively. AE occurred in 8 (44%) patients (death‐3, device embolization‐1, hemolysis‐1, surgical VSD closure‐2, reintervention‐1). Event‐free survival was 56% at 1 month and 5 years, and all AE occurred in the periprocedural period. Cardiogenic shock (HR: 3.21, CI: 1.82–5.41, P = 0.002), and VSD closure in acute phase (HR: 2.14, CI: 1.12–4.31, P = 0.004) were independent predictors of AE. In the non‐ischemic VSD subgroup, mean age and follow‐up was 49 ± 15 and 8.7 ± 8 years, respectively. AE occurred in 3 (33%) patients (late death‐1, surgical VSD closure‐2). For the entire cohort, freedom from death was 89% and 85% at 1 month and 5 years, and event‐free survival was 70% and 61% at 1 month and 5 years.
Conclusions
Transcatheter closure of post‐MI VSD carries a moderate risk of periprocedural complications but low event rates afterwards. By comparison, device closure of non‐ischemic VSD has lower periprocedural morbidity but some patients continued to experience AE during follow‐up. © 2015 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26033272</pmid><doi>10.1002/ccd.25989</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Catheterization and cardiovascular interventions, 2015-12, Vol.86 (7), p.1264-1270 |
| issn | 1522-1946 1522-726X |
| language | eng |
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| source | MEDLINE; Wiley Journals |
| subjects | Adult Aged Aged, 80 and over Cardiac Catheterization - adverse effects Cardiac Catheterization - instrumentation Cardiac Catheterization - mortality Disease-Free Survival Female Heart Septum - diagnostic imaging Heart Septum - injuries Humans Iatrogenic Disease Kaplan-Meier Estimate Male Middle Aged Minnesota myocardial infarction Myocardial Infarction - complications Myocardial Infarction - diagnosis Myocardial Infarction - mortality Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - mortality Postoperative Complications - therapy Proportional Hazards Models Radiography Retrospective Studies Risk Factors Septal Occluder Device Time Factors transcatheter Treatment Outcome ventricular septal defect Ventricular Septal Rupture - diagnosis Ventricular Septal Rupture - etiology Ventricular Septal Rupture - mortality Ventricular Septal Rupture - therapy |
| title | Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience |
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