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Novel Catheter Technique Successfully Patches Holes in the Heart

is composed of two discs connected by a thick shaft. The discs are made of flexible nitinol metal and covered in polyester fabric that encourages heart tissue to grow over the discs, completely covering them during healing.

Before implantation, the flexible double-disc patch is pulled into a catheter, collapsing and compressing it lengthwise. It is then threaded through a vein into the right ventricle and across the rupture into the left ventricle. The patch is pushed partially out of its catheter sheath until the first disc pops open. The catheter is then withdrawn back into the right ventricle, with the first disc positioned against the left ventricular wall and the connecting shaft filling the hole created by the rupture. From inside the right ventricle, the patch is pushed forward again, releasing the second disc, which covers the rupture on the right side of the heart.

Implantation of the VSD occluder was performed by Donald J. Hagler, M.D., FSCAI, a professor of pediatrics in the Divisions of Pediatric Cardiology and Cardiovascular Diseases at the Mayo Clinic. The procedure was successful in all patients, without complications. One patient died 5 days later of illness unrelated to the VSD patch. In 2 patients, the rupture didn't fully heal, causing damage to blood cells as they jetted through the narrow opening. A third patient developed a bacterial infection that started several months after device implantation. The patch was removed and all 3 patients had successful surgery to repair the rupture.

Even in such cases, the VSD patch serves its purpose by allowing patients to regain enough strength to withstand surgery, Dr. Martinez said. "Surgery is the long-term answer for some patients," he said. "In such cases, the VSD occluder successfully bridges the patients to surgery."

After a follow-up that averaged more than 1 year, patients were feeling markedly better and were much more active, even able to cl
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