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