| Objective(s): The purpose of this study was to investigate the effectiveness and safety of the Cardi-O-Fix plug in the treatment of muscular ventricle septal defect(m VSD),in order to provide experience and basis for the clinical application of the Cardi-O-Fix plug,and to provide new ideas for the interventional treatment of m VSD.Methods: The research retrospectively reviewed the 24 patients with m VSD from July 2015 to June 2021 in the Department of Cardiology of the First Affiliated Hospital of Kunming Medical University.According to the type of occluder,the patients were divided into two groups: 10 patients blocked with Cardi-O-Fix m VSD occluder as the control group,and 14 patients blocked with Cardi-O-Fix Plug as the experimental group.The basic information of the patients and relevant indicators of color doppler ultrasound before surgery,1 day after surgery and 1 month,3 months and 6 months of follow-up were collected.The preoperative data of the two groups were compared,including age,weight,the size of the left and right ventricles of m VSD,operation time,therapeutic effect,length of hospital stay,achievement ratio of operation,and complications(residual shunt,valve regurgitation and arrhythmia incidence),so as to explore the efficacy and safety of Cardi-O-Fix Plug occluders in the treatment of m VSD.Results:(1)Among the 24 children,22 cases were successfully performed interventional treatment and 2 cases were failed.The success rate of the experimental group 92.8%(13/14)was higher than that of the control group 90.0%(9/10).In terms of operation time,the average operation time of the experimental group(71.93±14.85)min was significantly reduced than that of the control group(90.70±19.78)min,with statistical difference(P < 0.05).(2)In the experimental group,13 patients were successfully performed interventional treatment,and1 patient failed to pass through the guide wire due to small defect,thus unable to establish the track;1 patient combined with PDA underwent successful device implantation.Among 13 patients,the type of 11 Cardi-O-Fix plugs was 10-12,1 CardiO-Fix plug was 08-10,1 Cardi-O-Fix plug was 06-08 be used to implant the m VSD,and the type of 1 Amplatzer Duct Occlude II plug was 08-10 be used to implant the PDA.One patient developed transient third-degree atrioventricular conduction block during the operation,and one patient developed small residual shunt after the operation,which disappeared completely after 3 months of follow-up.In the control group,9 patients were successfully performed interventional treatment,and 1 case failed to pass through the guide wire due to small defect,thus unable to establish the orbit.Among 9 patients,the type of 2 Cardi-O-Fix m VSD was 6mm,1 Cardi-O-Fix m VSD was 8mm,1 Cardi-O-Fix plug was 9mm,1 Cardi-O-Fix plug was 10 mm,2 Cardi-O-Fix m VSD was 12 mm,1 Cardi-O-Fix plug was 14 mm and 1 Cardi-O-Fix plug was 16 mm be used to implant the m VSD.Postoperative arrhythmias occurred in 3 cases(1 case of intermittent junctional escape beat,1 case of right bundle branch block,1 case of left anterior fascicular block),small residual shunt occurred in 2 cases,of which 1 case disappeared completely after 1 month of follow-up.4 cases developed valve regurgitation after surgery,including 1 case of mild tricuspid regurgitation and 2 cases of mild aortic regurgitation occurred after discharge,1 case of tricuspid regurgitation from slight to mild.(3)There were no serious complications such as residual shunt aggravation,occlude displacement,malignant arrhythmia,and infective endocarditis occurred in the two groups during the follow-up period.The left ventricular end-diastolic diameter and pulmonary artery pressure of the two groups were improved to varying degrees,while the indexes of heart size and cardiac systolic function at different time points were not significantly different between the two groups(P > 0.05).Conclusion(s): Compared with Cardi-O-Fix m VSD,Cardi-O-Fix Plug has a higher success rate and a lower probability of short and medium term arrhythmias in percutaneous catheter occlusion of the apical and trabecular parts of the m VSD.And the efficacy of Cardi-O-Fix Plug is reliable.However,the number of cases in this study is small and the follow-up time is short.The safety and reliability still need further longterm observation and exploration. |
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