ISSN: 1885-5857 Impact factor 2023 7.2
Vol. 74. Num. 7.
Pages 591-601 (July 2021)

Original article
Spanish registry of percutaneous VSD closure with NitOcclud Lê VSD Coil device: lessons learned after more than a hundred implants

Registro español de cierre percutáneo de comunicación interventricular con dispositivo NitOcclud Lê VSD-Coil. Experiencia tras más de 100 implantes

Ruth Solana-GraciaabAlberto Mendoza SotocJosé Ignacio Carrasco MorenodMaría Jesús del Cerro MaríneFederico Gutiérrez-Larraya AguadofJosé Félix Coserría SánchezgRoberto Blanco MatahFredy Hermógenes Prada MartíneziManuel Pan Álvarez-OssoriojLorenzo Jiménez MontañéskArmando Pérez de PradolMaría del Mar Rodríguez Vázquez del ReymHipólito Gutiérrez GarcíanJosé Manuel Velasco BayóncJosé Luis Zunzunegui Martínezbo
Rev Esp Cardiol. 2022;75:27910.1016/j.rec.2021.10.009
Fanyan Luo, Haisong Bu

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Abstract
Introduction and objectives

The NitOcclud Lê VSD Coil was specifically designed for transcatheter occlusion of ventricular septal defects (VSD) and became available for this purpose in August 2010. Our objective was to describe the Spanish experience of this technique and analyze its reliability and short- to mid-term efficacy.

Methods

National multicenter observational study, which retrospectively recruited all patients (of any age) with VSD (of any location or type) who underwent percutaneous NitOcclud occlusion, using an intention-to-treat analysis, until January 2019.

Results

A total of 117 attempts were made to implant at least 1 NitOcclud in 116 patients in 13 institutions. The median [range] age and weight was 8.6 [0.4-69] years and 27 [5.8-97] kg, respectively. In 99 patients (85%), the VSD was an isolated congenital defect. The location was perimembranous in 95 (81%), and 74 (63%) of them were aneurysmatic. The mean fluoroscopy time was 34 [11.4-124] minutes. Of the 117 attempts, 104 were successful (89%) with a follow-up of 31.4 [0.6-59] months. At the last review, final complete occlusion of the defect without residual shunt or with only a minimal shunt was achieved in 92.3% (no shunt, n=73; trivial shunt, n=23). Four patients required a second procedure for residual shunt occlusion. Two devices had to be surgically explanted due to severe hemolysis. There were no deaths or other major complications.

Conclusions

The NitOcclud device can be used successfully for a wide anatomical spectrum of VSD. The main issue is residual shunt, but its incidence decreases over time. The incidence of hemolysis was very low and no permanent changes were detected in atrioventricular conduction.

Keywords

Ventricular septal defect
Transcatheter closure
Congenital heart defects
NitOcclud Lê-VSD-Coil

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