Rahmat Budi Kuswiyanto, Eka Gunawijaya, Mulyadi M. Djer, Noormanto, Mahrus A. Rahman, Indah K. Murni, Rubiana Sukardi, Alit Utamayasa, Rizky Ardiansyah, Ria Nova, Sri Liliyanti, Sri E. Rahayuningsih, Shirley L. Anggriawan, Tri Yanti Rahayuningsih, Dyahris Koentartiwi, Renny Soewarniaty, Venny Kartika Yantie, Sasmito Nugroho, Taufiq Hidayat, Teddy Ontoseno, Tina C. Tobing, Muhamad Ali, Muhammad Hasan Bashari, Denny S. Yosy, Nadya Arafuri, Dany Hilmanto, Piprim B. Yanuarso, Najib Advani, Sudigdo Sastroasmoro, Sukman Tulus Putra
Background: The alternative device to close perimembranous ventricular septal defect (pmVSD) has been searched for better result, less complications and applicable for infants. However, the ideal device is still unavailable. We aimed to evaluate the effectiveness and outcome of transcatheter pmVSD closure using the KONAR-multi functional occluder (MFO). Methods: Clinical, procedural, follow-up data of pmVSD patients with symptom of heart failure or evidence of significant left to right shunt, growth failure, recurrent respiratory tract infection, and history of endocarditis who underwent transcatheter closure using the MFO were prospectively evaluated. Results: Between January 2016 and December 2017, there were complete records of 132 pmVSD children closed using MFO from eleven centers in Indonesia. The median of age was 4.5 (0.3-17.4) years; weight 14.8 (3.5-57) kg, defect size at the smallest part 3.4 (1.0-8.1) mm, flow ratio 1.6 (1.3-4.9), mean pulmonary artery pressure 18 (7-79) mmHg, fluoroscopy time 18 (3.8-91) and procedural time 75 (26-290) minutes. A retrograde approach was done in 41 (31%) patients. Procedures succeeded in first attempt in 126 (95.4%), failed in three and migration in three patients. Six of eight infants with congestive heart failure were closed successfully. Of 126 patients with successful VSD closure, 12 months follow-up were completed in all patients. The rate of complete occlusion at 1 month, 3 months, 6 months and 12 months after intervention were 95.2%, 97.6%, 99.2%, and 99.2%, respectively. New-onset aortic regurgitation and moderate tricuspid regurgitation developed only in five and three patients. Neither complete atrioventricular block, nor other complications occurred. Conclusion: Transcatheter closure of pmVSD using the MFO is safe, effective, and feasible in infants and children. © 2022 The Author(s)
Department of Pediatrics, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia; Department of Pediatrics, Sanglah Hospital, Universitas Udayana, Bali, Indonesia; Department of Pediatrics, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia; Department of Pediatrics, Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Pediatrics, Soetomo Hospital, Universitas Airlangga, Surabaya, Indonesia; Integrated Cardiac Center, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia; Department of Pediatrics, Adam Malik Hospital, USU, Medan, Indonesia; Department of Pediatrics, M. Hoesin Hospital, Universitas Sriwijaya, Palembang, Indonesia; Department of Pediatrics, Moewardi Hospital, UNS, Surakarta, Indonesia; Department of Pediatrics, Eka Hospital, Pekanbaru, Indonesia; Department of Pediatrics, Chasbullah Abdul Madjid Hospital, Bekasi, Indonesia; Department of Pediatrics, Saiful Anwar Hospital, Universitas Brawijaya, Malang, Indonesia; Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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