Amplatzer Ventricular Septal Occluder

The Importance of Treating Patients with VSD

Amplatzer VSD Occluders

The Amplatzer Muscular VSD Occluder is indicated for use in patients with a complex ventricular septal defect (VSD) of significant size to warrant closure—large volume left-to-right shunt, pulmonary hypertension, and/or clinical symptoms of congestive heart failure—in patients who are considered to be at high risk for standard transatrial or transarterialsurgical closure based on anatomical conditions and/or based on overall medical condition.

  • Benefits, Ease of Transcatheter Closure
    Mary Minette, et al.1

    “The benefits of avoiding [cardiopulmonary] bypass are intuitive, and the relative ease of placement makes this procedure ultimately attractive.”
     

     

When Closure Should be Performed

Both transcatheter and surgical closure are options for patients with moderate to large VSDs. In particular, physicians should perform VSD closure when the patient has:

  • Left ventricular (LV) volume overload
  • Worsening aortic regurgitation (AR) caused by perimembranous VSD   
  • Hemodynamically significant shunts, with pulmonary-to-systemic blood flow ratio (Qp/Qs) of 1.5 or higher*
  • A history of infective endocarditis (IE) caused by VSD

In patients whose VSD is not repaired, there is an increased risk of IE, usually involving the tricuspid and pulmonary valves.
 

*Assuming that PA systolic pressure is less than 50% systemic and pulmonary vascular resistance is less than one-third systemic.

Treatment for Post-MI Muscular VSD Is Critical

A post-myocardial infarction muscular VSD is a life-threatening complication that often leads to cardiogenic shock.3 Notably, medical management alone is associated with a grim prognosis of a 94% mortality rate at 30 days.4

  • Amplatzer Was “Just the Right Device” for VSD
    Cardiologist

    Due to his VSD Jozef developed endocarditis, which in turn led to heart failure and kidney failure. After receiving the Amplatzer VSD Occluder, Jozef, astonished at his symptom improvement, noted “I feel joy deep inside me—inside my heart.”

     

AP2947052-WBO Rev. A

References
  1. Minette MS, et al. Ventricular septal defects. Circulation. 2006;114:2190-2197.
  2. Stout KK, et al. 2018 AHA/ACC Guideline for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;000:e000-e000. doi: 10.1161/CIR.0000000000000603.
  3. Schlotter F, et al. Interventional post-myocardial infarction ventricular septal defect closure: a systematic review of current evidence. EuroIntervention. 2016;12:94-102.
  4. Crenshaw BS, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. Circulation. 2000;101(1):27-32.
     

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