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Percutaneous Device Closure of Congenital Isolated Ventricular Septal Defects: A Single-Center Retrospective Database Study Amongst 412 Cases

机译:经皮装置闭合先天性孤立的心室间隔缺损:412例中的单中心回顾数据库研究

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摘要

To identify suitable cases and reduce failure/complication rates for percutaneous ventricular septal defect (VSD) closure, we aimed to (1) study causes of device failure and (2) compare outcomes with different VSD types and devices in a high-volume single center with limited resources. Retrospective data of 412 elective percutaneous VSD closure of isolated congenital VSDs between 2003 and 2017 were analyzed. Out of 412, 363 were successfully implanted, in 30 device implantation failed, and in 19 the procedure was abandoned. Outcome was assessed using echocardiography, electrocardiography, and catheterization data (before procedure, immediately after and during follow-up). Logistic regression analyses were performed to assess effects of age, VSD type, and device type and size on procedural outcome. Median [interquartile range] age and body surface area were 6.6 [4.1–10.9] years and 0.7 [0.5–1.0] m2, respectively. Device failure was not associated with age (p?=?0.08), type of VSD (p?=?0.5), device type (p?=?0.2), or device size (p?=?0.1). Device failure occurred in 7.6% of patients. As device type is not related to failure rate and device failure and complication risk was not associated with age, it is justifiable to use financially beneficial ductal devices in VSD position and to consider closure of VSD with device in clinically indicated children.
机译:为了鉴定合适的病例并降低经皮心室间隔缺损(VSD)闭合的失效/并发症率,我们的目标是(1)器件故障的研究原因和(2)将不同的VSD类型和设备中的结果进行比较,在大批量单中心中资源有限。分析了412的回顾性数据,2003年至2017年间孤立先天性VSD的选修经皮VSD闭合。在412,363中成功植入了363个,在30个设备植入失败中,并且在19个程序被遗弃。使用超声心动图,心动图和导管数据(在手术前,在后续期后和在后续期间)进行评估结果。进行逻辑回归分析以评估年龄,VSD型和设备类型和规模对程序结果的影响。中位数[四分位数范围]年龄和体表面积分别为6.6 [4.1-10.9],分别为0.7 [0.5-1.0] M2。设备故障与年龄无关(P?= 0.08),VSD的类型(P?=?0.5),装置类型(P?= 0.2),或设备尺寸(P?=?0.1)。设备故障发生在7.6%的患者中。由于设备类型与故障率无关,并且设备故障和复杂风险与年龄无关,因此可以在VSD位置使用经济有益的导管器材,并考虑在临床指示的儿童中使用设备关闭VSD。

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