Experiences of two centers in percutaneous ventricular septal defect closure using konar multifunctional occluder

BACKGROUND: Transcatheter closure of perimembraneous ventricular septal defect still poses a challenge due to the adjacent structures of the tricuspid and aortic valves and the risk of atrioventricular block. We report our experience at 2 centers using the KONAR-MF (multifunctional occluder) ventricular septal defect device, which gained its CE mark in May 2018. METHODS: A retrospective study was carried out on all patients who underwent transcatheter ventricular septal defect closure with the KONAR-MF (multifunctional occluder) ventricular septal defect device at 2 centers. RESULTS: A total of 47 patients were identified. The median age and weight of the patients were 25.8 months and 11 kg. The ventricular septal defects that were closed in 5 cases were post-operative hemodynamically significant residual ventricular septal defects. Forty-eight devices were used in the 47 cases. As for the location of the ventricular septal defect, 40/48 (83.33%) ventricular septal defects were perimembranous and 8/48 (16.66%) were muscular. The percutaneous device closure was successful in 46 procedures (95.8%). Device embolization was observed in 2 patients, and a significant residual shunt was observed in 2 cases. In the follow-up, there was no enhancement in the residual shunt in the remaining cases. Temporary atrioventricular block occurred in 2 cases during the procedure and improved after long sheath withdrawal. CONCLUSION: Soft, flexible, and low-profile KONAR-MF (multifunctional occluder) occluders ensure easy and safe implantation, and small sheath sizes allow for their use in small infants. Although near and mid-term follow-ups did not indicate any permanent atrioventricular block, a larger sample of patients and a longer follow-up period is necessary to understand long-term outcomes

Retinopathy of Prematurity in Very Low Birth Weight Infants: Effects of Serum Vitamin A and Clinical Parameters

Pur po se: Retinopathy of prematurity (ROP) is a proliferative vascular disease which affects premature newborns and occurs during vessel development. The pathogenesis of ROP is complex and includes oxidative damage to the developing retina. The aim of this study was to evaluate the relationship of ROP with serum vitamin A levels and clinical parameters in infants with a gestational age of ≤32 weeks and birth weight of ≤1500 grams. Ma te ri al and Met hod: Newborns admitted to Newborn Intensive Care Unit within the first 24 hours of life, with gestational age ≤ 32 weeks, birth weight ≤1500 grams, without any major congenital anomalies, inborn error of metabolism or prior history of blood/blood products transfusion were included in the study. The patients were divided into two groups, ROP (+) and ROP (-), according to the presence of ROP at any stage. Serum vitamin A levels and gender, type of delivery, birth weight, gestational age, duration of hospitalization and oxygen supply, multiple gestation, preeclampsia, PDA, sepsis and intraventricular hemorrhage of the groups were compared with Mann-Whitney U and chi-square tests. Re sults: The mean gestational age of these infants was 29.2±2.0 weeks and the mean birth weight was 1287±197 grams. ROP was diagnosed in 48% of infants and the mean serum vitamin A level was 0.56±0.45 μmol/L. In 44 cases (84%), vitamin A level was determined low (<0.7 μmol/L) and was extremely low (<0.35 μmol/L) in 17 cases (32.7%). There was no significant difference between the ROP (+) and ROP (-) groups in terms of vitamin A levels. There was a statistically significant difference between the groups in terms of birth weight, gestational age, multiple gestation, duration of hospitalization and oxygen supply. Dis cus si on: Our results suggest that low birth weight, small gestational age, duration of hospitalization, oxygen exposure time and multiple gestation may increase the risk of ROP, while serum vitamin A level was not found to be associated with ROP in the present study. (Turk J Ophthalmol 2011; 41: 309-1