BACKGROUND: Transcatheter occlusion of ventricular septal defects (VSDs) was developed as an alternative to surgical treatment in the 80's. During anterograde device implantation, the formation of an arteriovenous loop with a guide-wire is technically difficult and time consuming. The aim of this study is to present the authors' experience with the retrograde approach and demonstrate its feasibility in different types of VSD. METHODS: Patients with VSD with no other associated defects were included in the study. Cases were selected by transthoracic echocardiograms. RESULTS: A total of eight patients were submitted to the procedure, 4 with muscular VSD and 4 with perimembranous VSD. Half of them were male, with ages ranging from 7 to 32 years (18.6 ± 7.8 years) and weight ranging from 30 to 97 kg (66.12 ± 24.7 kg). The defect diameter ranged from 2 to 8.6 mm (5 ± 2.4 mm). Implantation was possible in all patients and the most commonly used device was Lifetech CeraTM Type I. AmplatzerTM Muscular VSD Occluder, and Lifetech CeraTM Type II devices were also used. Two devices embolized immediately after implantation and were snared out. There was immediate occlusion in 75% of the cases. One patient had a complete atrioventricular block in the week following the procedure. The patient was treated with steroids, and was reverted to normal sinus rhythm. CONCLUSIONS: Retrograde transcatheter VSD occlusion with double disk devices proved to be effective in different types of VSD. The authors suggest this technique as an alternative to percutaneous occlusion of all types of VSD.
Heart septal defects, ventricular; Heart catheterization; Prostheses and implants; Heart defects, congenital
