Ventriküler Septal Defekt Girişimsel Tedavisi
Özet
Ventricular septal defekt (VSD), kalbin ventriküllerini ayıran septumda bulunan bir delik nedeniyle ortaya çıkan doğumsal bir kalp hastalığıdır. Bu bölümde, VSD'nin girişimsel tedavi seçenekleri detaylı bir şekilde ele alınmaktadır.
Girişimsel tedavi, cerrahi olmayan veya minimal invaziv prosedürlerle VSD'nin kapatılmasını amaçlar. Bu tedavi yöntemleri arasında kateter tabanlı kapama cihazları, cihazlarla desteklenmiş perkütan yöntemler ve diğer oklüzyon teknikleri yer almaktadır. Her bir yöntemin seçimi, VSD'nin büyüklüğü, yeri, hastanın klinik durumu ve diğer faktörlere bağlı olarak belirlenmelidir. Girişimsel tedavinin avantajları arasında minimal invaziv olması, hastanede kalış süresinin kısa olması ve daha hızlı iyileşme süreci bulunmaktadır.
Girişimsel tedavinin temel amacı, VSD'nin cerrahi risklerini ve komplikasyonlarını azaltmak, hastanın yaşam kalitesini artırmak ve kalıcı kardiyak sorunların önlenmesidir. Ancak, tedavi sırasında ve sonrasında dikkat edilmesi gereken önemli komplikasyonlar da bulunmaktadır. Bu komplikasyonlar, deneyimli kardiyologlar ve kardiyovasküler cerrahlar tarafından yönetilmelidir.
Sonuç olarak, girişimsel tedavi seçenekleri, VSD yönetiminde önemli bir rol oynamakta ve bu alandaki araştırma ve gelişmelerle birlikte sürekli olarak gelişmektedir. Bu bölüm, klinik pratiklerdeki güncel yaklaşımları ve gelecekteki yönelimleri anlamak için önemli bir kaynak sağlamaktadır.
Ventricular septal defect (VSD) is a congenital heart disease caused by a hole in the septum that separates the ventricles of the heart. In this section, interventional treatment options for VSD are discussed in detail.
Interventional treatment aims to close the VSD with non-surgical or minimally invasive procedures. These treatment methods include catheter-based occlusion devices, percutaneous methods supported by devices, and other occlusion techniques. The choice of each method should be determined based on the size and location of the VSD, the clinical condition of the patient, and other factors. The advantages of interventional treatment include being minimally invasive, short hospital stay, and faster recovery period.
The main purpose of interventional treatment is to reduce surgical risks and complications of VSD, improve the patient's quality of life and prevent permanent cardiac problems. However, there are also important complications that need to be considered during and after treatment. These complications should be managed by experienced cardiologists and cardiovascular surgeons.
As a result, interventional treatment options play an important role in the management of VSD and are constantly evolving with research and developments in this field. This chapter provides an important resource for understanding current approaches and future directions in clinical practice.
Referanslar
Lock JE, Block PC, McKay RG, Baim DS, Keane JF. Transcatheter closure of ventricular septal defects. Circulation. 1988 Aug;78(2):361-8. doi: 10.1161/01.cir.78.2.361. PMID: 3396173.
Rigby ML, Redington AN. Primary transcatheter umbrella closure of perimembranous ventricular septal defect. Br Heart J. 1994 Oct;72(4):368-71. doi: 10.1136/hrt.72.4.368. PMID: 7833197; PMCID: PMC1025549.
Kalra GS, Verma PK, Singh S, Arora R. Transcatheter closure of ventricular septal defect using detachable steel coil. Heart. 1999 Sep;82(3):395-6. doi: 10.1136/hrt.82.3.395. PMID: 10455098; PMCID: PMC1729174.
Sideris EB, Walsh KP, Haddad JL, Chen CR, Ren SG, Kulkarni H. Occlusion of congenital ventricular septal defects by the buttoned device. "Buttoned device" Clinical Trials International Register. Heart. 1997 Mar;77(3):276-9. doi: 10.1136/hrt.77.3.276. PMID: 9093050; PMCID: PMC484698.
Knauth AL, Lock JE, Perry SB, McElhinney DB, Gauvreau K, Landzberg MJ, Rome JJ, Hellenbrand WE, Ruiz CE, Jenkins KJ. Transcatheter device closure of congenital and postoperative residual ventricular septal defects. Circulation. 2004 Aug 3;110(5):501-7. doi: 10.1161/01.CIR.0000137116.12176.A6. Epub 2004 Jul 19. PMID: 15262841.
Rao PS. Management of Congenital Heart Disease: State of the Art; Part I-ACYANOTIC Heart Defects. Children (Basel). 2019 Mar 8;6(3):42. doi: 10.3390/children6030042. PMID: 30857252; PMCID: PMC6463202.
Michel-Behnke I, Ewert P, Koch A, Bertram H, Emmel M, Fischer G, Gitter R, Kozlik-Feldman R, Motz R, Kitzmüller E, Kretschmar O; Investigators of the Working Group Interventional Cardiology of the German Association of Pediatric Cardiology. Device closure of ventricular septal defects by hybrid procedures: a multicenter retrospective study. Catheter Cardiovasc Interv. 2011 Feb 1;77(2):242-51. doi: 10.1002/ccd.22666. PMID: 20517999.
Fu YC, Bass J, Amin Z, Radtke W, Cheatham JP, Hellenbrand WE, Balzer D, Cao QL, Hijazi ZM. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial. J Am Coll Cardiol. 2006 Jan 17;47(2):319-25. doi: 10.1016/j.jacc.2005.09.028. PMID: 16412854.
Hijazi ZM, Hakim F, Haweleh AA, Madani A, Tarawna W, Hiari A, Cao QL. Catheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: initial clinical experience. Catheter Cardiovasc Interv. 2002 Aug;56(4):508-15. doi: 10.1002/ccd.10292. PMID: 12124963.
Bass JL, Kalra GS, Arora R, Masura J, Gavora P, Thanopoulos BD, Torres W, Sievert H, Carminati M, Fischer G, Ewert P. Initial human experience with the Amplatzer perimembranous ventricular septal occluder device. Catheter Cardiovasc Interv. 2003 Feb;58(2):238-45. doi: 10.1002/ccd.10406. PMID: 12552550.
Butera G, Carminati M, Chessa M, Piazza L, Micheletti A, Negura DG, Abella R, Giamberti A, Frigiola A. Transcatheter closure of perimembranous ventricular septal defects: early and long-term results. J Am Coll Cardiol. 2007 Sep 18;50(12):1189-95. doi: 10.1016/j.jacc.2007.03.068. Epub 2007 Sep 4. PMID: 17868812.
Predescu D, Chaturvedi RR, Friedberg MK, Benson LN, Ozawa A, Lee KJ. Complete heart block associated with device closure of perimembranous ventricular septal defects. J Thorac Cardiovasc Surg. 2008 Nov;136(5):1223-8. doi: 10.1016/j.jtcvs.2008.02.037. Epub 2008 Jun 6. PMID: 19026807.
Tzikas A, Ibrahim R, Velasco-Sanchez D, Freixa X, Alburquenque M, Khairy P, Bass JL, Ramirez J, Aguirre D, Miro J. Transcatheter closure of perimembranous ventricular septal defect with the Amplatzer(®) membranous VSD occluder 2: initial world experience and one-year follow-up. Catheter Cardiovasc Interv. 2014 Mar 1;83(4):571-80. doi: 10.1002/ccd.25004. Epub 2013 Nov 13. PMID: 23703890.
Amin Z, Gu X, Berry JM, Bass JL, Titus JL, Urness M, Han YM, Amplatz K. New device for closure of muscular ventricular septal defects in a canine model. Circulation. 1999 Jul 20;100(3):320-8. doi: 10.1161/01.cir.100.3.320. PMID: 10411859.
Holzer R, Balzer D, Cao QL, Lock K, Hijazi ZM; Amplatzer Muscular Ventricular Septal Defect Investigators. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder: immediate and mid-term results of a U.S. registry. J Am Coll Cardiol. 2004 Apr 7;43(7):1257-63. doi: 10.1016/j.jacc.2003.10.047. PMID: 15063439.
El Said HG, Bratincsak A, Gordon BM, Moore JW. Closure of perimembranous ventricular septal defects with aneurysmal tissue using the Amplazter Duct Occluder I: lessons learned and medium term follow up. Catheter Cardiovasc Interv. 2012 Nov 15;80(6):895-903. doi: 10.1002/ccd.23074. Epub 2012 Aug 20. PMID: 22907908.
El-Sisi A, Sobhy R, Jaccoub V, Hamza H. Perimembranous Ventricular Septal Defect Device Closure: Choosing Between Amplatzer Duct Occluder I and II. Pediatr Cardiol. 2017 Mar;38(3):596-602. doi: 10.1007/s00246-016-1553-x. Epub 2017 Mar 1. PMID: 28251252.
Ghosh S, Sridhar A, Sivaprakasam M. Complete heart block following transcatheter closure of perimembranous VSD using amplatzer duct occluder II. Catheter Cardiovasc Interv. 2018 Nov 1;92(5):921-924. doi: 10.1002/ccd.27177. Epub 2017 Jul 14. PMID: 28707408.
Haas NA, Kock L, Bertram H, Boekenkamp R, De Wolf D, Ditkivskyy I, Freund MW, Gewillig M, Happel CM, Herberg U, Karthasyan E, Kozlik-Feldmann R, Kretschmar O, Kuzmenko Y, Milanesi O, Mueller G, Pongiglione G, Schubert S, Tarusinov G, Kampmann C. Interventional VSD-Closure with the Nit-Occlud® Lê VSD-Coil in 110 Patients: Early and Midterm Results of the EUREVECO-Registry. Pediatr Cardiol. 2017 Feb;38(2):215-227. doi: 10.1007/s00246-016-1502-8. Epub 2016 Nov 15. PMID: 27847970.
Esteves CA, Solarewicz LA, Cassar R, Neves JR, Esteves V, Arrieta R. Occlusion of the perimembranous ventricular septal defect using CERA® devices. Catheter Cardiovasc Interv. 2012 Aug 1;80(2):182-7. doi: 10.1002/ccd.24371. Epub 2012 May 4. PMID: 22431503.
Yang R, Kong XQ, Sheng YH, Zhou L, Xu D, Yong YH, Sun W, Zhang H, Cao KJ. Risk factors and outcomes of post-procedure heart blocks after transcatheter device closure of perimembranous ventricular septal defect. JACC Cardiovasc Interv. 2012 Apr;5(4):422-7. doi: 10.1016/j.jcin.2012.01.015. PMID: 22516400.
Holzer R, de Giovanni J, Walsh KP, Tometzki A, Goh T, Hakim F, Zabal C, de Lezo JS, Cao QL, Hijazi ZM. Transcatheter closure of perimembranous ventricular septal defects using the amplatzer membranous VSD occluder: immediate and midterm results of an international registry. Catheter Cardiovasc Interv. 2006 Oct;68(4):620-8. doi: 10.1002/ccd.20659. PMID: 16969878.
Referanslar
Lock JE, Block PC, McKay RG, Baim DS, Keane JF. Transcatheter closure of ventricular septal defects. Circulation. 1988 Aug;78(2):361-8. doi: 10.1161/01.cir.78.2.361. PMID: 3396173.
Rigby ML, Redington AN. Primary transcatheter umbrella closure of perimembranous ventricular septal defect. Br Heart J. 1994 Oct;72(4):368-71. doi: 10.1136/hrt.72.4.368. PMID: 7833197; PMCID: PMC1025549.
Kalra GS, Verma PK, Singh S, Arora R. Transcatheter closure of ventricular septal defect using detachable steel coil. Heart. 1999 Sep;82(3):395-6. doi: 10.1136/hrt.82.3.395. PMID: 10455098; PMCID: PMC1729174.
Sideris EB, Walsh KP, Haddad JL, Chen CR, Ren SG, Kulkarni H. Occlusion of congenital ventricular septal defects by the buttoned device. "Buttoned device" Clinical Trials International Register. Heart. 1997 Mar;77(3):276-9. doi: 10.1136/hrt.77.3.276. PMID: 9093050; PMCID: PMC484698.
Knauth AL, Lock JE, Perry SB, McElhinney DB, Gauvreau K, Landzberg MJ, Rome JJ, Hellenbrand WE, Ruiz CE, Jenkins KJ. Transcatheter device closure of congenital and postoperative residual ventricular septal defects. Circulation. 2004 Aug 3;110(5):501-7. doi: 10.1161/01.CIR.0000137116.12176.A6. Epub 2004 Jul 19. PMID: 15262841.
Rao PS. Management of Congenital Heart Disease: State of the Art; Part I-ACYANOTIC Heart Defects. Children (Basel). 2019 Mar 8;6(3):42. doi: 10.3390/children6030042. PMID: 30857252; PMCID: PMC6463202.
Michel-Behnke I, Ewert P, Koch A, Bertram H, Emmel M, Fischer G, Gitter R, Kozlik-Feldman R, Motz R, Kitzmüller E, Kretschmar O; Investigators of the Working Group Interventional Cardiology of the German Association of Pediatric Cardiology. Device closure of ventricular septal defects by hybrid procedures: a multicenter retrospective study. Catheter Cardiovasc Interv. 2011 Feb 1;77(2):242-51. doi: 10.1002/ccd.22666. PMID: 20517999.
Fu YC, Bass J, Amin Z, Radtke W, Cheatham JP, Hellenbrand WE, Balzer D, Cao QL, Hijazi ZM. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial. J Am Coll Cardiol. 2006 Jan 17;47(2):319-25. doi: 10.1016/j.jacc.2005.09.028. PMID: 16412854.
Hijazi ZM, Hakim F, Haweleh AA, Madani A, Tarawna W, Hiari A, Cao QL. Catheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: initial clinical experience. Catheter Cardiovasc Interv. 2002 Aug;56(4):508-15. doi: 10.1002/ccd.10292. PMID: 12124963.
Bass JL, Kalra GS, Arora R, Masura J, Gavora P, Thanopoulos BD, Torres W, Sievert H, Carminati M, Fischer G, Ewert P. Initial human experience with the Amplatzer perimembranous ventricular septal occluder device. Catheter Cardiovasc Interv. 2003 Feb;58(2):238-45. doi: 10.1002/ccd.10406. PMID: 12552550.
Butera G, Carminati M, Chessa M, Piazza L, Micheletti A, Negura DG, Abella R, Giamberti A, Frigiola A. Transcatheter closure of perimembranous ventricular septal defects: early and long-term results. J Am Coll Cardiol. 2007 Sep 18;50(12):1189-95. doi: 10.1016/j.jacc.2007.03.068. Epub 2007 Sep 4. PMID: 17868812.
Predescu D, Chaturvedi RR, Friedberg MK, Benson LN, Ozawa A, Lee KJ. Complete heart block associated with device closure of perimembranous ventricular septal defects. J Thorac Cardiovasc Surg. 2008 Nov;136(5):1223-8. doi: 10.1016/j.jtcvs.2008.02.037. Epub 2008 Jun 6. PMID: 19026807.
Tzikas A, Ibrahim R, Velasco-Sanchez D, Freixa X, Alburquenque M, Khairy P, Bass JL, Ramirez J, Aguirre D, Miro J. Transcatheter closure of perimembranous ventricular septal defect with the Amplatzer(®) membranous VSD occluder 2: initial world experience and one-year follow-up. Catheter Cardiovasc Interv. 2014 Mar 1;83(4):571-80. doi: 10.1002/ccd.25004. Epub 2013 Nov 13. PMID: 23703890.
Amin Z, Gu X, Berry JM, Bass JL, Titus JL, Urness M, Han YM, Amplatz K. New device for closure of muscular ventricular septal defects in a canine model. Circulation. 1999 Jul 20;100(3):320-8. doi: 10.1161/01.cir.100.3.320. PMID: 10411859.
Holzer R, Balzer D, Cao QL, Lock K, Hijazi ZM; Amplatzer Muscular Ventricular Septal Defect Investigators. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder: immediate and mid-term results of a U.S. registry. J Am Coll Cardiol. 2004 Apr 7;43(7):1257-63. doi: 10.1016/j.jacc.2003.10.047. PMID: 15063439.
El Said HG, Bratincsak A, Gordon BM, Moore JW. Closure of perimembranous ventricular septal defects with aneurysmal tissue using the Amplazter Duct Occluder I: lessons learned and medium term follow up. Catheter Cardiovasc Interv. 2012 Nov 15;80(6):895-903. doi: 10.1002/ccd.23074. Epub 2012 Aug 20. PMID: 22907908.
El-Sisi A, Sobhy R, Jaccoub V, Hamza H. Perimembranous Ventricular Septal Defect Device Closure: Choosing Between Amplatzer Duct Occluder I and II. Pediatr Cardiol. 2017 Mar;38(3):596-602. doi: 10.1007/s00246-016-1553-x. Epub 2017 Mar 1. PMID: 28251252.
Ghosh S, Sridhar A, Sivaprakasam M. Complete heart block following transcatheter closure of perimembranous VSD using amplatzer duct occluder II. Catheter Cardiovasc Interv. 2018 Nov 1;92(5):921-924. doi: 10.1002/ccd.27177. Epub 2017 Jul 14. PMID: 28707408.
Haas NA, Kock L, Bertram H, Boekenkamp R, De Wolf D, Ditkivskyy I, Freund MW, Gewillig M, Happel CM, Herberg U, Karthasyan E, Kozlik-Feldmann R, Kretschmar O, Kuzmenko Y, Milanesi O, Mueller G, Pongiglione G, Schubert S, Tarusinov G, Kampmann C. Interventional VSD-Closure with the Nit-Occlud® Lê VSD-Coil in 110 Patients: Early and Midterm Results of the EUREVECO-Registry. Pediatr Cardiol. 2017 Feb;38(2):215-227. doi: 10.1007/s00246-016-1502-8. Epub 2016 Nov 15. PMID: 27847970.
Esteves CA, Solarewicz LA, Cassar R, Neves JR, Esteves V, Arrieta R. Occlusion of the perimembranous ventricular septal defect using CERA® devices. Catheter Cardiovasc Interv. 2012 Aug 1;80(2):182-7. doi: 10.1002/ccd.24371. Epub 2012 May 4. PMID: 22431503.
Yang R, Kong XQ, Sheng YH, Zhou L, Xu D, Yong YH, Sun W, Zhang H, Cao KJ. Risk factors and outcomes of post-procedure heart blocks after transcatheter device closure of perimembranous ventricular septal defect. JACC Cardiovasc Interv. 2012 Apr;5(4):422-7. doi: 10.1016/j.jcin.2012.01.015. PMID: 22516400.
Holzer R, de Giovanni J, Walsh KP, Tometzki A, Goh T, Hakim F, Zabal C, de Lezo JS, Cao QL, Hijazi ZM. Transcatheter closure of perimembranous ventricular septal defects using the amplatzer membranous VSD occluder: immediate and midterm results of an international registry. Catheter Cardiovasc Interv. 2006 Oct;68(4):620-8. doi: 10.1002/ccd.20659. PMID: 16969878.