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Novel Catheter Technique Successfully Patches Holes in the Heart

A novel catheter technique for patching holes in the heart may make it possible for many patients to avoid surgery altogether and others to regain enough strength to safely undergo surgical repair at a later date, according to a study reported at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions, May 912, 2007, in Orlando, FL.

The patch successfully closed ventricular septal defects(VSDs)or ruptures in the wall between the right and left ventriclesin nearly all patients, allowing blood to circulate normally again and relieving fluid back-up in the lungs. After recovery, patients were able to return to active lives.

"Patients with acute VSDs may be critically ill with heart failure and perhaps be in cardiogenic shock," said Matthew W. Martinez, M.D., a cardiology fellow at the Mayo Clinic in Rochester, MN. "This procedure offers an alternative for patients who are too sick to undergo emergency heart surgery or simply don't want surgery."

To track the long-term effectiveness of the catheter procedure, Dr. Martinez and his colleagues reviewed the medical records of 10 patients treated with the VSD patch between 1995 and 2005. Of these, 5 patients experienced rupture of the ventricular wall, or septum, as a result of a heart attack. In the other 5 patients, the VSD was an unintended consequence of a previous heart surgery.

In all cases, the VSD allowed a portion of the blood in the left ventricle to shoot backward into the right ventricle with each heart beat, rather than being circulated to the rest of the body. As a result, patients were experiencing such severe heart failure they were short of breath at rest or with minimal activity, and were judged to have New York Heart Association class 3 and 4 heart failure.

A variety of patches were used in the study, but all were some form of AMPLATZER Occluder (AGA Medical Corp., Plymouth, MN). The VSD patch
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