VSD devices
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Transcript of VSD devices
VSD DEVICES
COMPLICATIONS OF VSD DEVICES (29% cases, mostly minor)
• EMBOLISATION (2-5%)
• ARRHYTHMIAS (mostly transient)
• CONDUCTION DEFECTS (2-3% CHB)
• AR/TR (9% mostly resolves within 6 months)
• RESIDUAL LEAK (upto 60% cases with post MI VSD device closure)
• LOCAL PUNCTURE SITE COMPLICATIONS
AMPLATZER MUSCULAR VSD DEVICE
• SYMMETRIC
• WAIST length 7 mm ,Discs exceed waist by 8 mm
• Dacron fabric incorporated
• Sizes 4-18 mm
AMPLATZER ASYMMETRIC VSD OCCLUDER• very short (1.5 mm) connecting waist to
minimise contact with the tricuspid valve.
• In its latest design the left sided disk extends 5 mm towards the apex (with a platinum marker) to lean firmly on the muscular septum and only 0.5 mm towards the aorta to avoid contact with the aortic valve
• The right sided disk is 4 mm larger than the waist.
• The prosthesis is filled with Dacron fabric to facilitate thrombosis.
• Prostheses are available in sizes ranging from 4–12 mm at increments of 2 mm
AMPLATZER PERIMEMBRANOUS VSD DEVICES
• Allows for placement that avoids interference with the aortic or atrioventricular valves
• Devices range from 4 to 18 mm, in single mm increments
• LV disk is 6 mm larger, RV disk is 4 mm larger than waist
AMPLATZER POST MI VSD DEVICE• Symmetric,Waist 10 mm, discs 10 mm larger
• Sizes 16-24 mm(less than required!!)
• Dacron incorporated
• 20% have complete closure,60% have small residual leak,20% have moderate leak
• 28% mortality at 30 days
POST MI VSD CLOSURE RESULTS
Kaulfersch, Dähnert, Schuler, Thiele Minerv Cardioangiol 2007;55:693-701
MADE IN CHINA……!!
• YATAI Scientific corporation
• Polyester fabrics sewn in frame
LIFETECH
• Nitinol mesh • Polyester• Pure Stainless Steel tip• e PTFE membrane
NIT OCCLUD VSD COIL
• Novel attachment mechanism, 6 Fr delivery catheter
• Controlled released coil similar to the PDA NitOcclud
• Stiff distal loops covered with Dacron filaments
• Distal coil diameter: 10, 12, 14, 18 mm• Prox coil diameter: 6, 6, 8, 10 mm
THANKS