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Eur J Cardiothorac Surg 2005;27:714-716
© 2005 Elsevier Science NL

How-to-do-it

Closure of left ventricle perforation with the use of muscular VSD occluder

Magorzata Pawelec-Wojtalik^a,*, Ludwig Karl von Segesser^b, Ma Liang^b, Dorota Bukowska^c

^a Department of Pediatric Radiology, University of Medical Sciences, Poznan, Poland
^b Department of Cardio-Vascular Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, Lausanne, Switzerland
^c Department of Veterinary Medicine, University of Agriculture, Poznan, Poland

Received 27 October 2004; received in revised form 31 December 2004; accepted 3 January 2005.

^* Corresponding author. Address: Department of Angiography and Haemodynamics, University of Medical Sciences, Ul. Szpitalna 27/33, 60-572 Poznan, Poland. Tel.: +48 603 681182; fax: +48 61 8669130. (E-mail: mpwojt{at}poczta.onet.pl).

Growing experience in interventional cardiology leads to the use of large diameter of vascular equipment. In some instances, the so-called hybrid procedures are performed. After performing the interventional procedure, the opening in ventricular wall is closed surgically. Our intention was to check if the MVSDO can be used to close the perforation in the heart after the interventional cardiology procedure performed through the left ventricular (LV) free wall. In three pigs under general anesthesia, the heart was exposed through a small substernal incision. The LV was punctured and an 18F sheath was introduced into the LV. A 14mm MVSDO was inserted through the 10F Delivery System. Using both the echocardiographic and angiographic guidance, the MVSDO was placed on the LV wall to close the opening in the LV. Time and volume of bleeding was recorded. In all cases the occluder was successfully placed closing the opening, bleeding observed after deployment of occluder lasted for approximately 2min. We think MVSD occluder can be used to close the LV free wall perforation after hybrid interventional cardiac procedure. Early bleeding through MVSDO might be resolved by the manufacturing of new occluder with better sealing properties.

Key Words: Amplatzer device • Interventional cardiology • Hybrid cardiology procedures

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