This document summarizes different devices used for closing ventricular septal defects (VSDs). It describes the common complications of VSD devices which are mostly minor, including embolization, arrhythmias, and conduction defects. Three types of Amplatzer devices are outlined - the muscular VSD device, asymmetric VSD occluder, and perimembranous VSD devices. Sizes and designs of each are provided. Results of post-myocardial infarction VSD closure show high residual leak rates. Finally, it briefly mentions some VSD devices manufactured in China including by Yatai and Lifetech, and introduces the novel NitOcclud VSD coil.

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