VSD devices

1. VSD DEVICES

2. 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

3. AMPLATZER MUSCULAR VSD DEVICE
• SYMMETRIC
• WAIST length 7 mm ,Discs
exceed waist by 8 mm
• Dacron fabric incorporated
• Sizes 4-18 mm

4. 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

5. 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

6. 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

7. POST MI VSD CLOSURE RESULTS
Kaulfersch, Dähnert, Schuler, Thiele Minerv Cardioangiol 2007;55:693-701

8. MADE IN CHINA……!!
• YATAI Scientific
corporation
• Polyester fabrics sewn
in frame

9. LIFETECH
•
•
•
•
Nitinol mesh
Polyester
Pure Stainless Steel tip
e PTFE membrane

10. 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

11. THANKS